Bertram B, Schulte-Stracke U, Wolf S, Schulte K, Arend O, Remky A, Reim M
Augenklinik, RWTH Aachen.
Ophthalmologe. 1994 Feb;91(1):81-5.
In 22 patients with acute arteriosclerotic anterior ischemic optic neuropathy (AION), examinations were conducted before the start of therapy and between 1 and 3 years later. In the acute stage of the disease the patients were treated with hemodilution for 10 days. The visual acuity improved from 0.2 to 0.4 (median). Compared with the visual acuity before therapy, at the follow-up 1-3 years later visual acuity had improved by 3 lines or more in 11 patients, remained stationary in 9 patients (+/- 1 line), and worsened in 2 patients by 3 lines or more. The visual fields (Goldmann) improved in 8 patients, did not change in 10 patients and worsened in 4 patients. After 1-3 years, 14 patients (64%) showed a sectorial pallor and 8 patients (36%) a diffuse pallor of the optic disc. Videofluorescein angiography revealed hypofluorescent discs in all patients. No difference in arm-retina time (ART) was found between the acute phase (13.0 +/- 3.3 s) and the examination 1-3 years later (13.1 +/- 2.2 s). ART was within normal limits in all patients. The arteriovenous passage time (AVP) dropped significantly, from 2.36 (+/- 0.81) s in the acute phase to 1.91 (+/- 0.56) s 1-3 years later. However, the AVP still did not fall to normal levels (1.45 +/- 0.40 s). Slowed retinal hemodynamics (AVP) with normal ART at the same time suggests a disturbance in microcirculation still present 1-3 years after the acute phase of AION. The rheological parameters (hematocrit, plasma viscosity, erythrocyte aggregation index) did not show any change between examinations.(ABSTRACT TRUNCATED AT 250 WORDS)
对22例急性动脉硬化性前部缺血性视神经病变(AION)患者在治疗开始前及1至3年后进行了检查。在疾病急性期,患者接受了10天的血液稀释治疗。视力中位数从0.2提高到了0.4。与治疗前的视力相比,1至3年后的随访中,11例患者视力提高了3行或更多,9例患者视力保持稳定(±1行),2例患者视力下降了3行或更多。8例患者的视野(Goldmann)改善,10例患者未改变,4例患者恶化。1至3年后,14例患者(64%)视盘出现扇形苍白,8例患者(36%)视盘出现弥漫性苍白。荧光素血管造影显示所有患者视盘低荧光。急性期(13.0±3.3秒)与1至3年后检查时的臂-视网膜时间(ART)无差异。所有患者的ART均在正常范围内。动静脉通过时间(AVP)显著下降,从急性期的2.36(±0.81)秒降至1至3年后的1.91(±0.56)秒。然而,AVP仍未降至正常水平(1.45±0.40秒)。AION急性期后1至3年,视网膜血流动力学减慢(AVP)而ART正常,提示微循环仍存在障碍。检查之间血液流变学参数(血细胞比容、血浆粘度、红细胞聚集指数)未显示任何变化。(摘要截断于250字)