Gu X Z, Tsai J C, Wurdeman A, Wall M, Foote T, Sadun A A
Doheny Eye Institute, USC School of Medicine, Los Angeles 90033-4671, USA.
Curr Eye Res. 1995 Mar;14(3):173-80. doi: 10.3109/02713689509033512.
There is both clinical and histopathologic evidence for peripheral visual field loss and optic nerve degeneration in longstanding papilledema due to idiopathic intracranial hypertension (IIH). The purpose of this study was to look at the extent and distribution of axonal dropout in secondary optic atrophy due to IIH. Both optic nerves from a 29-year-old man with a two year history of IIH were examined histologically and morphometrically. A high-contrast lipid (myelin) stain, paraphenylenediamine (PPD), and a semiautomated image analysis system were employed to resolve sufficiently the optic nerve fiber images for counts and for measurement. There were 80% and 90% losses of axons, respectively, in the right and left optic nerves consequent to IIH. The axonal loss in the peripheral area of each optic nerve was much more severe than that in inner sectors (= 0.001 for the right optic nerve and = 0.005 for the left). This pattern of axonal dropout is consistent with the preservation of good central visual acuity despite devastating optic nerve atrophy, and with the severe peripheral visual field loss noted in this patient.
对于特发性颅内高压（IIH）所致的长期视乳头水肿，存在周边视野缺损和视神经变性的临床及组织病理学证据。本研究的目的是观察IIH所致继发性视神经萎缩中轴突缺失的程度和分布。对一名有两年IIH病史的29岁男性的双侧视神经进行了组织学和形态学检查。采用高对比度脂质（髓磷脂）染色、对苯二胺（PPD）和半自动图像分析系统，以充分分辨视神经纤维图像用于计数和测量。由于IIH，右侧和左侧视神经的轴突分别损失了80%和90%。每条视神经周边区域的轴突损失比内侧区域严重得多（右侧视神经P = 0.001，左侧视神经P = 0.005）。这种轴突缺失模式与尽管视神经严重萎缩但中心视力良好得以保留相一致，也与该患者严重的周边视野缺损相符。
