Hondur Ahmet M, Moazami Golnaz, Hondur Gozde, Tezel Tongalp H
Columbia University, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, New York, New York; Gazi University, Department of Ophthalmology, Ankara, Turkey.
Columbia University, Department of Ophthalmology, Vagelos College of Physicians and Surgeons, New York, New York.
Ophthalmology. 2025 Mar;132(3):327-334. doi: 10.1016/j.ophtha.2024.09.008. Epub 2024 Sep 12.
To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.
Case-control study.
Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).
The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).
The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.
The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.
Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.
研究非动脉炎性缺血性视神经病变（NAION）中的玻璃体视乳头界面，以寻找可能易导致视神经灌注缺陷的特征。
病例对照研究。
将NAION患者（研究组）与患有视盘拥挤的健康非NAION患者（对照组I）和视盘不拥挤的健康非NAION患者（对照组II）进行比较。
使用高分辨率光学相干断层扫描（OCT）对32只患有NAION的眼睛的玻璃体视乳头界面进行研究。将结果与两个对照组进行比较，这两个对照组由年龄、性别和屈光匹配的非NAION个体组成，其中一组视盘拥挤（对照组I：31只眼睛），另一组视盘不拥挤（对照组II：32只眼睛）。
完全性玻璃体后脱离（PVD）、玻璃体视乳头及玻璃体血管附着以及视乳头表面膜的发生率。
各组黄斑区的PVD发生率相似（NAION组：62.5%，对照组I：61.3%，对照组II：65.6%，P = 0.93），而玻璃体后皮质与拥挤视盘的附着率显著更高（NAION组：81.2%，对照组I：83.9%，对照组II：43.7%，P = 0.0005）。观察到拥挤视盘上的局灶性玻璃体视乳头附着率高于不拥挤视盘（NAION组：72.2%，拥挤的对照组I：58.7%，不拥挤的对照组II：19.1%，P = 0.007）。在NAION组眼中观察到玻璃体血管附着（NAION组：68.8%，拥挤的对照组I：3.2%，不拥挤的对照组II：6.3%，P = 0.00001）以及致密的视乳头表面膜。
视盘拥挤可能有更强的玻璃体视乳头附着。这些附着与视神经血管的密切关系可能导致在玻璃体凝胶液化后，由收缩的玻璃体凝胶传递强大的牵拉力，尤其是在黄斑区PVD之后。这种传导的机械力可能使血管壁扭曲并破坏NAION中的血流。
在本文末尾的脚注和披露中的参考文献之后可能会找到专有或商业披露信息。
