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find Keyword "前部缺血性视神经病变" 5 results
  • 球后视神经炎与前部缺血性视神经病变的图形视觉诱发电位分析

    目的 研究球后视神经炎与前部缺血性视神经病变患者在图形视觉诱发电位(pattern visual evoked potential,P-VEP)上的改变。 方法 对临床上确诊为球后视神经炎的患者 34 例共 41 只眼、前部缺血性视神经病变的患者 30 例共 38 只眼以及无任何眼部疾病的正常者 25 例共 50 只眼进行 P-VEP 检查,比较分析球后视神经炎与前部缺血性视神经病变患者、正常者相比 P-VEP 的 P100 波潜伏时及振幅的改变。 结果 球后视神经炎组患者 P-VEP 的 P100 波潜伏时为(111.93±9.16)ms,振幅为(10.69±7.29)μV;前部缺血性视神经病变组患者 P100 波潜伏时为(115.11±11.91)ms,振幅为(8.29±4.96)μV;正常组 P100 波潜伏时为(100.61±4.14)ms,振幅为(13.74±4.78)μV。球后视神经炎组患者与正常组相比 P-VEP 的 P100 波潜伏时差异有统计学意义(P<0.001),振幅之间的差异无统计学意义(P=0.071);前部缺血性视神经病变组患者与正常组相比 P-VEP 的 P100 波潜伏时与振幅差异均有统计学意义(P<0.001);前部缺血性视神经病变组患者与球后视神经炎组患者相比 P-VEP 的 P100 波潜伏时与振幅差异均无统计学意义(P=0.059)。 结论 球后视神经炎与前部缺血性视神经病变患者的 P-VEP 均有所改变,球后视神经炎患者主要表现为潜伏时的改变,而前部缺血性视神经病变患者在潜伏时与振幅上均有所改变,但两组患者间 P-VEP 的差别不明显。因此,P-VEP 可以作为诊断球后视神经炎与前部缺血性视神经病变的重要依据,但是 P-VEP 的改变不能作为鉴别诊断视神经炎与前部缺血性视神经病变的指标,若要鉴别这两种疾病还需要联合其他检查手段才能完成。

    Release date:2017-04-19 10:17 Export PDF Favorites Scan
  • Choroidal thickness in Chinese patients with non-arteritic anterior ischemic optic neuropathy

    Objective To observe the peripapillary choroidal thicknesses (pCT) and subfoveal choroidal thicknesses (SFCT) of nonarteritic anterior ischemic optic neuropathy (NAION). Methods Forty-four Chinese patients with unilateral NAION were recruited and compared with 60 eyes of 60 normal age and refractive-error matched control subjects. pCT and SFCT were measured by enhanced depth imaging optical coherence tomography. Choroidal thicknesses of eyes with NAION and unaffected fellow eyes were compared with normal controls. Choroidal thicknesses of NAION eyes with or without optic disc edema were also compared. The correlation between choroidal thickness and retinal nerve fiber layer (RNFL) thickness, logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and the mean deviation (MD) of Humphrey static perimetry in NAION eyes were analyzed. Results The pCT at the nasal, nasal inferior and temporal inferior quadrants in NAION eyes with optic disc edema were significantly thicker than that of normal subjects (t=3.152, 3.166, 2.808; P<0.05). There was no significant difference in the choroidal thicknesses between the unaffected fellow eyes of NAION patients and normal eyes of healthy controls; or between the NAION eyes with resolved optic disc edema and normal eyes (P>0.05). No significant correlation between choroidal thickness (r=-0.220, -0.140, 0.110), SFCT (r=0.096, -0.148, -0.131) and logMAR BCVA, perimetry MD and RNFL was found in eyes affected by NAION (P>0.05). Conclusions The peripapillary choroidal thicknesses increase in some quadrants in NAION eyes with optic disc edema. However, the choroidal thickness of NAION eyes is the same in age and refractive error-matched normal subjects.

    Release date:2017-09-19 03:09 Export PDF Favorites Scan
  • Screening and diagnostic system construction for optic neuritis and non-arteritic anterior ischemic optic neuropathy based on color fundus images using deep learning

    Objective To construct and evaluate a screening and diagnostic system based on color fundus images and artificial intelligence (AI)-assisted screening for optic neuritis (ON) and non-arteritic anterior ischemic optic neuropathy (NAION). MethodsA diagnostic test study. From 2016 to 2020, 178 cases 267 eyes of NAION patients (NAION group) and 204 cases 346 eyes of ON patients (ON group) were examined and diagnosed in Zhongshan Ophthalmic Center of Sun Yat-sen University; 513 healthy individuals of 1 160 eyes (the normal control group) with normal fundus by visual acuity, intraocular pressure and optical coherence tomography examination were collected from 2018 to 2020. All 2 909 color fundus images were as the data set of the screening and diagnosis system, including 730, 805, and 1 374 images for the NAION group, ON group, and normal control group, respectively. The correctly labeled color fundus images were used as input data, and the EfficientNet-B0 algorithm was selected for model training and validation. Finally, three systems for screening abnormal optic discs, ON, and NAION were constructed. The subject operating characteristic (ROC) curve, area under the ROC (AUC), accuracy, sensitivity, specificity, and heat map were used as indicators of diagnostic efficacy. ResultsIn the test data set, the AUC for diagnosing the presence of an abnormal optic disc, the presence of ON, and the presence of NAION were 0.967 [95% confidence interval (CI) 0.947-0.980], 0.964 (95%CI 0.938-0.979), and 0.979 (95%CI 0.958-0.989), respectively. The activation area of the systems were mainly located in the optic disc area in the decision-making process. ConclusionAbnormal optic disc, ON and NAION, and screening diagnostic systems based on color fundus images have shown accurate and efficient diagnostic performance.

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  • 复发性非动脉炎性前部缺血性视神经病变3例

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  • Clinical characteristics and analysis of 49 misdiagnosed nonarteritic anterior ischemic optic neuropathy patients

    Objective To observed and analyze the clinical features of patients with nonarteritic anterior ischemic optic neuropathy (NAION) causes of misdiagnosis. MethodsA retrospective case study. From November 2014 to July 2022, 49 NAION patients with 49 eyes diagnosed in Department of Ophthalmology, The First People’s Hospital of Lanzhou were included in the study. All patients were misdiagnosed with other eye diseases at first diagnosis. All eyes were examined by best corrected visual acuity (BCVA), relative afferent pupil defect (RAPD), orbital magnetic resonance imaging (MRI), visual field, optical coherence tomography (OCT), and graphic visual evoked potential (P-VEP). Fluorescein fundus angiography (FFA) was performed in 32 eyes. Clinical and MRI, visual field, P-VEP、FFA features of the patients were retrospectively analyzed. ResultsThere were 31 males and 18 females among the 49 patients. All cases were monocular. Age was (59.3±7.8) years. All of them complained of painless visual acuity loss or occlusion sensation in one eye. There were 12 (24.5%, 12/49) and 37 (75.6%, 37/49) cases with disease duration >2 months and ≤2 months, respectively. In 49 eyes, misdiagnosed as optic neuritis, normal tension glaucoma (NTG) or suspected glaucoma, optic disc vasculitis, cataract, diabetic retinopathy, traumatic optic neuropathy and toxic optic neuropathy were 28 (57.1%, 28/49), 11 (22.4%, 11/49), 5 (10.2%, 5/49), 2 (4.1%, 2/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49) eyes. 24 (49.0%, 24/49), 16 (32.7%, 16/49) and 9 (18.4%, 9/49) eyes had BCVA<0.1, 0.1-0.5 and>0.5, respectively. RAPD was positive in 45 eyes (91.8%, 45/49). There were 37 (75.6%, 37/49) and 12 (24.5%, 12/49) eyes with and without optic disc edema, respectively. Bleeding was observed on and around the optic disc in 15 eyes (30.6%, 15/49). MRI examination showed no obvious abnormality in the optic nerve segments of all affected eyes. OCT showed an increase in retinal nerve fiber layer thickness (307.1±62.1) μm in 37 patients with optic disc edema. The visual field examination showed that 24 eyes (49.0%, 24/49) had typical lower visual field defect connected with the physiological blind spot and circumvented the central fixation point, 6 eyes (12.2%, 6/49) had limited visual field defect connected with the physiological blind spot, and 19 eyes (38.8%, 19/49) had diffuse visual field defect. By P-VEP examination, the amplitude of P100 wave decreased moderately to severely in all affected eyes. There were 24 eyes (49.0%, 24/49) with mild peak delay and 11 eyes (22.4%, 11/49) with moderate peak delay. In 32 eyes examined by FFA, the arteries had early peridisk limitation or diffuse delayed filling, and mid-course fluorescein leakage in the corresponding area. ConclusionsThe main symptoms of NAION patients are painless visual acuity loss in one eye or occlusion of vision. The main clinical features of NAION patients are visual field defect, retinal nerve fiber layer thickening and visual electrophysiological abnormalities. NAION patients with acute or subacute visual loss accompanied by optic disc edema and/or bleeding are often misdiagnosed as optic neuritis, optic neurovasculitis and other types of optic neuropathy. NAION patients with a disease course of >2 months are easily misdiagnosed as NTG.

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