中国患者非动脉性前缺血性视神经病变与视神经炎的临床差异:回顾性比较病例系列研究

Jun Chen, W. Zhao, Zacharia Ackbarkhan, Jianfeng He, Yi Du
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摘要

本研究的目的是比较中国非动脉性前缺血性视神经病变(NAION)和视神经炎(ON)患者的临床特征。回顾性比较23例(23眼)NAION和62例(80眼)ON的临床特点,包括一般情况、表现、辅助检查。双眼同时发病(29.03% vs. 0%, p=0.009)和眼动疼痛(23.75% vs. 0%, p=0.022)在on患者中比NAION患者更常见。ON患者的眼痛(32.5% vs. 4.35%, p=0.007)高于NAION患者。NAION患者视盘水肿(100% vs. 62.5%, p<0.001)、乳头周围出血(47.83% vs. 10%, p<0.001)和乳头周围硬渗出(17.39% vs. 1.25%, p=0.009)较ON患者更为常见。在荧光素血管造影中,NAION患者早期部分或全部乳头状低荧光(65.21%比22.86%,p<0.001)、乳头周围脉管炎充血延迟(73.91%比14.29%,p<0.001)和晚期部分乳头状高荧光(52.17%比25.71%,p=0.019)的比例高于ON患者。中国患者的NAION和ON的临床特征有惊人的重叠,它们仍然具有一些特征性的临床特征,可以用来区分两种疾病。
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Clinical Differences Between Nonarteritic Anterior Ischemic Optic Neuropathy and Optic Neuritis in Chinese Patients: A Retrospective Comparative Case Series Study
The aim of this study is to compare the clinical features between nonarteritic anterior ischemic optic neuropathy (NAION) and optic neuritis (ON) in Chinese patients. The clinical features of 23 cases (23 eyes) of NAION and 62 cases (80 eyes) of ON, including their general conditions, manifestations, auxiliary examinations were retrospectively compared. Simultaneous onset of bilateral eye (29.03% vs. 0%, p=0.009) and pain on movement of the eyes (23.75% vs. 0%, p=0.022) were more common in ON patients in comparison to NAION patients. Ocular pain (32.5% vs. 4.35%, p=0.007) was higher in ON patients than that in NAION patients. Optic disc edema (100% vs. 62.5%, p<0.001), peripapillary hemorrhage (47.83% vs. 10%, p<0.001) and peripapillary hard exudates (17.39% vs. 1.25%, p=0.009) in NAION patients were more common compared to ON patients,. During fluorescein angiography, the rates of the partial or whole papillary hypofluorescent in early phase (65.21% vs. 22.86%, p<0.001), peripapillary choroidal filling delay (73.91% vs. 14.29%, p<0.001) and partial papillary hyperfluorescent in later phase (52.17% vs. 25.71%, p=0.019) were higher in NAION patients than those in ON patients. The clinical features of NAION and ON in Chinese patients reveal a surprising overlap and they still have some characteristic clinical features that can be utilized to differentiate the two diseases.
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