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世界核心医学期刊文摘(眼科学分册) 2006年第3期 23-24页

作者： Hayreh S.S Zimmerman B. 陈立军 Departmentof Ophthalmology and Visual sciences UniversityHospitals and Clinics 200 Hawkins Dr Iowa City IA52242-1091 United states Dr.

Objective: To evaluate the pattern of various types of visual field defects and their prevalence at initial examination of nonarteritic anterior ischemic optic neuropathy (NA-AION).Methods: The data were compiled from 312 consecutive eyes (in 265 patients)that fulfilled our inclusion and exclusion criteria. A comprehensive ophthalmic evaluation was performed, includingre cording of visual acuity, visual fields with a Goldmann perimeter (using I-2e, I-4e, and V-4e targets regularly), and intraocular pressure; slitlamp examination of the anterior segment;ophthalmoscopy; color fundus photography; and in acute cas.s, fluorescein fundus angiography. The visual field defects were divided into 2 groups: (1) general field defects and (2)-various types of scotoma in the central 30°. The prevalence of various types of visual field defects was estimated for I-2e, I-4e, and V-4e isopters by dividing the total number of eyes with thedefect by the total number of eyes that could see that particulartarget. Exact 95%confidence limits for the prevalence were computed. Results: Of the 265 patients, 169 (63.7%) were male and the mean±sD patient age was 55.0±9.1 years. The median interval between the first visual field test and the onset of NA-AION was 2 weeks. Of the 312 eyes, the I-2e target was.seen by 75.3%, the I-4e target by 90.7%, and the V-4e targetby 100%. Overall prevalence of general visual field defects was 83.4%with I-2e, 78.8%with I-4e, and 68.9%with V-4e,whereas the prevalence of scotoma(s) within the central 30°was 55.3%, 49.5%, and 36.2%, respect ively. Central scotoma was.seen in 48.5%with I-2e, 43.8%with I-4e, and 29.2%with V-4e. A detailed prevalence of various types of visualfield defects is given. Relative inferior altitudinal defect was most common (34.9%with I-2e and 22.3%with I-4e), but the absolute inferior altitudinal defect was.seen in only 8.0%. Bycontrast, absolute inferior nasal sector visual loss was the most common defect detected in NA-AION (22.4%), but it occurredin only 3.4%with I-2e and 11.0%with

关键词：非动脉炎性前部缺血性视神经病变视野缺损患病率

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视网膜中央动脉阻塞:视力预后

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世界核心医学期刊文摘(眼科学分册) 2006年第1期 4-4页

作者： Hayreh S.S. Zimmerman M.B. 杨秀梅 Department of Ophthalmology and Visual sciences University Hospitals and Clinics 200 Hawkins Drive Iowa City IA 52242-1091 United states Dr

PURPOsE: To investigate s.stematically the natural history of visual outcome in central retinal artery occlusion (CRAO). DEsIGN: Cohort study. METHODs: At entry, 244 consecutive patients (260 eyes) with CRAO (seen consecutively from 1973 to 2000) had a detailed ocular and medical history and ocular evaluation. CRAO eyes were classified into four categories: non-arteritic (NA) CRAO (171 eyes), NA-CRAO with cilioretinal artery sparing (35), transient NA-CRAO (41), and arteritic CRAO (13). REsULTs: Within 7 days of onset of CRAO, initial visual acuity differed among the four CRAO types (Ps with vision of counting fingers or worse, it improved in 82% of eyes with transient NA-CRAO, 67% of eyes with NA-CRAO with cilioretinal artery sparing, and 22% of eyes with NA-CRAO. Visual acuity improved primarily within the first 7 days (P sual field, central scotoma was most common. Central visual field improved in 39% with transient NA-CRAO, 25% with NA-CRAO with cilioretinal artery sparing, and 21% with NA-CRAO. Peripheral visual field was normal in 62.9% of eyes with transient NA-CRAO and 22.1% in those with NA-CRAO. In 51.9% of eyes with NA-CRAO, the only remaining visual field was a peripheral island. Peripheral fields improved in NA-CRAO (39% ) and in transient NA-CRAO (39% ). CONCLUsIONs: Classification of CRAO is crucial for understanding differences in visual outcome. Marked improvement in visual acuity and visual field can occur without treatment and is determined by several factors. Visual field information is essential to evaluate visual disability in CRAO.

关键词：视力预后睫状体侧支循环一过性 AO 葡萄膜视网膜中央动脉阻塞周边视野

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