WuDunn D, Zimmerman K, Sadun A A, Feldon S E
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
Ophthalmology. 1997 Jan;104(1):104-11. doi: 10.1016/s0161-6420(97)30354-6.
Although previous studies have examined the risk of bilaterality of nonarteritic ischemic optic neuropathy (NAION), none have compared extensively the extent of visual loss between fellow eyes. The authors examined cases of bilateral NAION to determine the extent of vision loss in the second eye compared with that in the first eye.
Thirty-one cases of bilateral NAION were reviewed. Variables included age, gender, and the presence of comorbid disease. Visual function was assessed by Snellen visual acuity, color vision, and pattern and mean deviation of the visual fields.
No correlation was detected between the extent or pattern of visual loss in fellow eyes. No significant difference in visual function existed between first and second eyes for the patients overall. Patients who retained better visual function in the second eye were significantly older than those who retained better visual function in the first eye (visual acuity, P = 0.0005; color vision, P = 0.07; mean deviation, P = 0.02). In patients older than 50 years of age (25 of 31 cases), the second eye had significantly better visual acuity (P = 0.04) and less Humphrey visual field mean deviation (P = 0.04) than the first eye.
Visual function in the second eye correlated poorly with that of the first eye. Older patients with bilateral NAION retained better visual function in the second eye than in the first eye. For younger patients, the extent of visual loss in the second eye could not be predicted based on the visual loss in the first eye.
尽管先前的研究已探讨非动脉炎性缺血性视神经病变（NAION）双侧发病的风险，但尚无研究广泛比较双眼视力丧失的程度。作者对双侧NAION病例进行研究，以确定第二只眼与第一只眼相比的视力丧失程度。
回顾了31例双侧NAION病例。变量包括年龄、性别和合并疾病的存在情况。通过Snellen视力、色觉以及视野的模式偏差和平均偏差评估视觉功能。
未发现双眼视力丧失程度或模式之间存在相关性。总体而言，患者的第一只眼和第二只眼在视觉功能上无显著差异。第二只眼保留较好视觉功能的患者明显比第一只眼保留较好视觉功能的患者年龄更大（视力，P = 0.0005；色觉，P = 0.07；平均偏差，P = 0.02）。在年龄大于50岁的患者中（31例中的25例），第二只眼的视力明显更好（P = 0.04），Humphrey视野平均偏差更小（P = 0.04）。
第二只眼的视觉功能与第一只眼的视觉功能相关性较差。患有双侧NAION的老年患者第二只眼的视觉功能比第一只眼更好。对于年轻患者，无法根据第一只眼的视力丧失情况预测第二只眼的视力丧失程度。
