Hayreh S S, Joos K M, Podhajsky P A, Long C R
Department of Ophthalmology, College of Medicine, University of Iowa, Iowa City.
Am J Ophthalmol. 1994 Dec 15;118(6):766-80. doi: 10.1016/s0002-9394(14)72557-7.
We investigated, in nonarteritic anterior ischemic optic neuropathy, the prevalence of various systemic diseases before or at its onset and the incidence of subsequent morbidity and mortality.
We investigated prospectively the presence of systemic diseases before or at the onset of nonarteritic anterior ischemic optic neuropathy in 406 patients. The information was obtained by complete medical history and physical examination. The prevalence rates of systemic diseases in young, middle-aged, and elderly groups were compared with those in the general population. We also analyzed the influence of systemic diseases on subsequent morbidity and mortality.
Compared with the prevalences reported in the general population, our patients in each of the three age groups showed a significantly higher prevalence of arterial hypertension (P < or = .02), diabetes mellitus (P < .01), and gastrointestinal ulcer (P < or = .02). Also, middle-aged and elderly patients showed a significantly higher prevalence of ischemic heart disease (P < .01) and thyroid disease (P < .01). Middle-aged patients had significantly higher rates of chronic obstructive pulmonary disease and cerebrovascular disease (P < or = .01). After onset of anterior ischemic optic neuropathy, patients with both arterial hypertension and diabetes mellitus had a significantly higher incidence of cerebrovascular disease (P < .01).
Nonarteritic anterior ischemic optic neuropathy is a multifactorial disease in which some systemic diseases may act as predisposing factors and others as precipitating factors. Patients with anterior ischemic optic neuropathy show no significant increase in mortality, but those with both arterial hypertension and diabetes mellitus have significantly (P < .01) increased incidence of cerebrovascular disease.
我们对非动脉炎性前部缺血性视神经病变患者在发病前或发病时各种全身性疾病的患病率以及随后的发病率和死亡率进行了调查。
我们前瞻性地调查了406例非动脉炎性前部缺血性视神经病变患者在发病前或发病时全身性疾病的情况。这些信息通过完整的病史和体格检查获得。将青年、中年和老年组全身性疾病的患病率与普通人群的患病率进行比较。我们还分析了全身性疾病对随后发病率和死亡率的影响。
与普通人群报告的患病率相比，我们三个年龄组的患者中，动脉高血压（P≤0.02）、糖尿病（P＜0.01）和胃肠道溃疡（P≤0.02）的患病率显著更高。此外，中年和老年患者缺血性心脏病（P＜0.01）和甲状腺疾病（P＜0.01）的患病率显著更高。中年患者慢性阻塞性肺疾病和脑血管疾病的发生率显著更高（P≤0.01）。前部缺血性视神经病变发病后，患有动脉高血压和糖尿病的患者脑血管疾病的发生率显著更高（P＜0.01）。
非动脉炎性前部缺血性视神经病变是一种多因素疾病，其中一些全身性疾病可能作为易感因素，另一些则作为促发因素。前部缺血性视神经病变患者的死亡率没有显著增加，但患有动脉高血压和糖尿病的患者脑血管疾病的发生率显著增加（P＜0.01）。
