Zhang Wei, Sun Xin-Quan, Peng Xiao-Yan
Beijing Tongren Eye Hospital, Capital Medical University, Beijing 100730, China.
China-Japanese Friendship Hospital, Beijing 100029, China.
World J Clin Cases. 2021 Jul 26;9(21):5830-5839. doi: 10.12998/wjcc.v9.i21.5830.
Anterior ischemic optic neuropathy (AION) is a group of ophthalmic diseases in which the optic nerve is injured causing blindness. However, the pathogenesis, clinical manifestations, and clinical treatments of AION are yet elusive. Only a few related experimental or clinical reports are available on the disease. In this study, spectral domain optical coherence tomography (SD-OCT) was used to examine the morphology of thickness swelling and atrophic changes of macular ganglion cell complex (mGCC) in the different stages of AION that were then compared with the visual fields. Thus, the clinical value of mGCC examination was alleged to be similar to that of the visual field.
To explore the mGCC injury at different stages in AION and the clinical significance.
Cases with AION were analyzed in a retrospective study. SD-OCT was used to analyze the correlation between mGCC and peripapillary retinal nerve fiber layer thicknesses at different stages of AION and the changes in the corresponding stages of visual fields.
A total of 21 cases (28 eyes) presented AION. The onset time of AION was defined as early stage (within 3 wk of onset), middle stage (from 3 wk to 2 mo), and late stage (disease span > 2 mo). In the early stage, the mGCC thickness of SD-OCT was within the normal high limit, and the perioptic nerve fibers thickness was more than the normal. The changes in the visual field in early stage were not consistent with the swelling changes in mGCC and peri-disc nerve fibers. In addition, atrophy and thinning appeared in mGCC, and the perioptic nerve fibers were swollen. However, the thickness was lower in the middle period than that in the early stage. The change in visual field was consistent with that of mGCC in this period. In the late stage, mGCC shrank and thinned, and the thickness of the nerve fibers around the optic disc in the corresponding region shrank and thinned.
The changes in mGCC thickness in patients with AION showed early, middle, and late stages of development by SD-OCT. Although the early stage visual field changes of AION were not consistent with the swelling changes of mGCC, the horizontal delimitation or annular atrophy of mGCC was consistent with that in the middle and late stage of the disease. The atrophy of peripheral nerve fibers was later than that of the mGCC atrophy.
前部缺血性视神经病变（AION）是一组因视神经受损而导致失明的眼科疾病。然而，AION的发病机制、临床表现及临床治疗方法仍不明确。关于该疾病，仅有少数相关的实验或临床报告。在本研究中，采用光谱域光学相干断层扫描（SD - OCT）检查AION不同阶段黄斑神经节细胞复合体（mGCC）的厚度肿胀及萎缩变化形态，然后将其与视野进行比较。因此，据称mGCC检查的临床价值与视野检查相似。
探讨AION不同阶段的mGCC损伤情况及临床意义。
对AION病例进行回顾性研究分析。利用SD - OCT分析AION不同阶段mGCC与视乳头周围视网膜神经纤维层厚度之间的相关性以及相应阶段视野的变化。
共有21例（28只眼）出现AION。将AION的发病时间定义为早期（发病3周内）、中期（发病3周后至2个月）和晚期（病程超过2个月）。在早期，SD - OCT显示mGCC厚度处于正常上限范围内，视盘周围神经纤维厚度超过正常。早期视野变化与mGCC及视盘周围神经纤维的肿胀变化不一致。此外，mGCC出现萎缩变薄，视盘周围神经纤维肿胀，但中期厚度低于早期。此阶段视野变化与mGCC变化一致。在晚期，mGCC萎缩变薄，相应区域视盘周围神经纤维厚度也萎缩变薄。
通过SD - OCT可显示AION患者mGCC厚度变化呈现早期、中期和晚期发展阶段。虽然AION早期视野变化与mGCC肿胀变化不一致，但mGCC的水平界限或环形萎缩与疾病中晚期一致。周围神经纤维萎缩晚于mGCC萎缩。
