Katz B, Spencer W H
Department of Ophthalmology, California Pacific Medical Center, San Francisco.
Am J Ophthalmol. 1993 Dec 15;116(6):754-8. doi: 10.1016/s0002-9394(14)73477-4.
The most convincing morphologic component in the pathogenesis of nonarteritic anterior ischemic optic neuropathy is the anatomically small and crowded optic nerve head. Because the appearance of the optic disk is presumed to be related to underlying refractive error, we sought to determine if a particular refractive error places patients at additional risk for, or affords protection from, nonarteritic anterior ischemic optic neuropathy. We compared refractive errors of 50 patients with nonarteritic anterior ischemic optic neuropathy to an age-matched and eye-matched control population. The mean refractive error (in spherical equivalents) for the nonarteritic anterior ischemic optic neuropathy group was +0.26 diopter (SD +/- 2.08); the mean refractive error for controls was -0.86 diopter (SD +/- 2.91) (P = .027). Our results suggest that patients who have nonarteritic anterior ischemic optic neuropathy are less myopic than a control population. Whether it is myopia that protects from, or hyperopia that predisposes to nonarteritic anterior optic neuropathy, our results imply another anatomically based factor that characterizes eyes that develop nonarteritic anterior ischemic optic neuropathy. Those eyes tend to be minimally hyperopic.
非动脉炎性前部缺血性视神经病变发病机制中最具说服力的形态学因素是解剖结构上较小且拥挤的视神经乳头。由于视盘外观被认为与潜在的屈光不正有关，我们试图确定某种特定的屈光不正是否会使患者发生非动脉炎性前部缺血性视神经病变的风险增加，或提供保护作用。我们将50例非动脉炎性前部缺血性视神经病变患者的屈光不正情况与年龄匹配、眼睛匹配的对照人群进行了比较。非动脉炎性前部缺血性视神经病变组的平均屈光不正（以等效球镜度计）为+0.26屈光度（标准差±2.08）；对照组的平均屈光不正为-0.86屈光度（标准差±2.91）（P = 0.027）。我们的结果表明，患有非动脉炎性前部缺血性视神经病变的患者比对照人群近视程度更低。无论是近视起到保护作用，还是远视易引发非动脉炎性前部缺血性视神经病变，我们的结果都意味着另一个基于解剖结构的因素可用来描述发生非动脉炎性前部缺血性视神经病变的眼睛特征。这些眼睛往往仅有轻微远视。
