Nonarteritic anterior ischemic optic neuropathy: Time of onset of visual loss
Nonarteritic anterior ischemic optic neuropathy: Time of onset of visual loss
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DOI：
10.1016/s0002-9394(14)70902-x
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发表时间：
1997-11-01
影响因子：
4.2
通讯作者：
Zimmerman, B
中科院分区：
文献类型：
--
作者：
Hayreh, SS;Podhajsky, PA;Zimmerman, B
目的：研究非动脉性前缺血性视神经病变（AION）视力丧失发病的时间和季节变化。方法：从1975年至1995年，对635例（871只眼）aion患者共925次发现视力丧失的时间进行前瞻性调查。数据分析了两个变量：544例发现视力丧失的时间和839例AION发病的季节变化。结果：在544例发作中，发现视力丧失的时间为早晨从睡眠中醒来或午睡时，282例（51.8%），117例（21.5%）在清晨第一次有机会使用视力时，145例（26.7%）在白天晚些时候。AION在夏季的发生率明显高于冬季（P = 0.0030）。估计每月发病率为夏季82.7例（95%可信区间[CI]， 71.3 ~ 95.8），冬季58.3例（95% CI, 48.9 ~ 69.6），春季66.0例（95% CI, 55.9 ~ 71.9），秋季72.7例（95% CI, 62.1 ~ 85.1）。炎热月份的发病率明显高于寒冷月份（P < 0.0001），估计炎热月份的月发病率为82.2次（95% CT， 73.7至91.8），而寒冷月份的月发病率为59.8次（95% CI， 53.3至67.1）。结论：在544例AION发作中，至少399例（73.3%）患者在首次醒来或首次醒来时发现视力丧失。提示夜间动脉低血压可能起重要作用。此外，AION多发于夏季而非冬季。
PURPOSE: To study time of day and seasonal variation of onset of: visual loss in nonarteritic anterior ischemic optic neuropathy (AION).METHODS: From 1975 to 1995, we prospectively investigated the time of discovery of visual loss in 635 patients (871 eyes) with AION-a total of 925 episodes. Data were analyzed for two variables: time of day of discovery of visual loss for 544 episodes and seasonal variation of the onset of AION for 839 episodes.RESULTS: Of 544 episodes, time of day for discovery of visual loss was upon awakening from sleep in the morning or a nap in 282 (51.8%), during the first opportunity to use vision critically early in the morning in 117 (21.5%), and later in the day in 145 (26.7%). AION was significantly (P = .0030) more frequent in summer than winter. Estimated monthly onset rates were 82.7 episodes (95% confidence interval [CI], 71.3 to 95.8) in summer, 58.3 (95% CI, 48.9 to 69.6) in winter, 66.0 (95% CI, 55.9 to 71.9) in spring, and 72.7 (95% CI, 62.1 to 85.1) in fall. Onset significantly (P < .0001) occurred more during hot than cold months, with the estimated monthly rate of onset in hot months of 82.2 episodes (95% CT, 73.7 to 91.8) compared with 59.8 (95% CI, 53.3 to 67.1) in cold months.CONCLUSIONS: Tn at least 399 (73.3%) of 544 episodes of AION, patients discovered visual loss upon first awakening or at first. opportunity to use vision critically after sleeping, suggesting that nocturnal arterial hypotension may play an important role, Also, AION developed more often in summer than in winter.