Spraul C W, Amann J, Lang G E, Lang G K
Universitäts-Augenklinik, Ulm.
Ophthalmologe. 1996 Aug;93(4):354-60.
Nonarteritic anterior ischemic optic neuropathy (AION) is the most common cause of visual loss in older patients with optic disc swelling.
In our study all patients with acute AION examined clinically and by fluorescein angiography between 1986 and 1994 were retrospectively reviewed. The prevalence of associated systemic diseases and the results of Doppler sonographic examinations of extracranial vessels were investigated.
The records of 86 patients (60 male, 26 female) with AION were available. The mean age at the time of onset of AION was 61 years (range 41 to 85 years, SD = 11.9 years). In 50 patients the right and in 36 the left eye was involved. In 36% of the patients optic atrophy of the other eye because of AION was found. The median visual acuity was 0.25 (range, light perception to 1.25). Fluorescein angiography showed diffuse edema of the optic disc in 23% (20/86) of patients and localized segmental edema in 77% (66/86). Statistical analysis revealed a predominant involvement of the temporal quadrants. Ninety-three percent of patients with AION showed underlying systemic diseases. In 15% of these patients the systemic diseases were unknown at the time of onset of the AION; 58% (50/86) of the patients had hypertension, 28% (24/86) had diabetes mellitus, and 37% (32/86) had disorders of lipid metabolism. Seven percent (6/86) of patients showed no risk factors. Doppler sonographic examinations of extracranial vessels revealed hemodynamic relevant stenosis in 11% (6/56), and non stenotic plaques in 28% of patients (16/56).
Because of the high percentage of associated systemic diseases in patients with AION a general examination and adequate treatment are necessary.
非动脉炎性前部缺血性视神经病变（AION）是老年视盘肿胀患者视力丧失的最常见原因。
回顾性分析1986年至1994年间临床检查并经荧光素血管造影检查的所有急性AION患者。调查相关全身性疾病的患病率及颅外血管多普勒超声检查结果。
可获取86例AION患者（60例男性，26例女性）的记录。AION发病时的平均年龄为61岁（范围41至85岁，标准差=11.9岁）。50例患者右眼受累，36例患者左眼受累。36%的患者因AION发现对侧眼视神经萎缩。中位视力为0.25（范围，光感至1.25）。荧光素血管造影显示23%（20/86）的患者视盘弥漫性水肿，77%（66/86）的患者局限性节段性水肿。统计分析显示颞侧象限受累为主。93%的AION患者存在潜在的全身性疾病。其中15%的患者在AION发病时全身性疾病不明；58%（50/86）的患者患有高血压，28%（24/86）的患者患有糖尿病，37%（32/86）的患者存在脂质代谢紊乱。7%（6/86）的患者无危险因素。颅外血管多普勒超声检查显示11%（6/56）的患者存在血流动力学相关狭窄，28%（16/56）的患者存在非狭窄斑块。
由于AION患者中相关全身性疾病的比例较高，因此进行全面检查和适当治疗是必要的。
