Chee Shew Fei, Chew Chang Feng, Zunaina Embong
Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.
Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Ipoh, MYS.
Cureus. 2023 Mar 6;15(3):e35823. doi: 10.7759/cureus.35823. eCollection 2023 Mar.
Background To analyze the etiology of optic disc swelling (ODS) and compare the clinical features between non-arteritic anterior ischemic optic neuropathy (NA-AION) and optic neuritis (ON) at our center from January 2019 to January 2020. Methodology Clinical records of all patients who presented with ODS between January 2019 and January 2020 were reviewed. The collected data were analyzed using IBM SPSS Statistics for Windows (Version 23.0, IBM Corp., Armonk, NY, USA). Results A total of 70 eyes among 47 patients were included in this review. There were 24 patients (51%) who had unilateral ODS, while 23 patients (49.0%) had bilateral ODS. The most common etiology of unilateral ODS was ON (45.7%), NA-AION (25%), and neuroretinitis (12.5%). Among bilateral ODS, the most common cause was papilledema (30.4%), hypertensive retinopathy (21.7%), diabetic papillitis (13.1%), and optic disc drusen (13.1%). Among unilateral ODS, the mean onset age was significantly older in NA-AION cases than that in ON cases (57.5 years vs. 40.3 years, = 0.016). Ocular pain was a significant clinical finding observed in ON cases (54.5%) and none in NA-AION cases (= 0.043). Although there was no significant difference in the initial visual acuity (VA) between NA-AION and ON, the final VA was significantly improved in ON compared to NA-AION (0.31 ± 0.34 vs. 1.14 ± 1.00, = 0.029). Conclusions Many differential diagnoses must be considered when a patient is presented with ODS. With the increased prevalence of hypertension and diabetes in Malaysia, it is not a surprise that both hypertensive retinopathy and diabetic papillitis together accounted for one-third of the bilateral ODS patients.
分析视盘肿胀（ODS）的病因，并比较2019年1月至2020年1月在我院非动脉炎性前部缺血性视神经病变（NA-AION）和视神经炎（ON）的临床特征。方法：回顾2019年1月至2020年1月期间所有出现ODS患者的临床记录。使用IBM SPSS Statistics for Windows（版本23.0，IBM公司，美国纽约州阿蒙克）对收集的数据进行分析。结果：本研究共纳入47例患者的70只眼。24例患者（51%）为单侧ODS，23例患者（49.0%）为双侧ODS。单侧ODS最常见的病因是ON（45.7%）、NA-AION（25%）和神经视网膜炎（12.5%）。在双侧ODS中，最常见的原因是视乳头水肿（30.4%）、高血压性视网膜病变（21.7%）、糖尿病性视乳头炎（13.1%）和视盘玻璃疣（13.1%）。在单侧ODS中，NA-AION病例的平均发病年龄显著高于ON病例（57.5岁对40.3岁，P = 0.016）。眼痛是ON病例中观察到的显著临床特征（54.5%），而NA-AION病例中无眼痛（P = 0.043）。尽管NA-AION和ON之间的初始视力（VA）无显著差异，但与NA-AION相比，ON的最终视力显著改善（0.31±0.34对1.14±1.00，P = 0.029）。结论：当患者出现ODS时，必须考虑许多鉴别诊断。随着马来西亚高血压和糖尿病患病率的增加，高血压性视网膜病变和糖尿病性视乳头炎共同占双侧ODS患者的三分之一也就不足为奇了。
