Fundus lesions in malignant hypertension. V. Hypertensive optic neuropathy.
Fundus lesions in malignant hypertension. V. Hypertensive optic neuropathy.
复制标题
恶性高血压的眼底病变。
DOI：
10.1016/s0161-6420(86)33773-4
复制
发表时间：
1986
期刊：
影响因子：
13.7
通讯作者：
Virdi,PS
中科院分区：
文献类型：
--
作者：
Hayreh,SS;Servais,GE;Virdi,PS
我们在57只恒河猴中通过改良Goldblatt的程序制作了实验性肾血管性动脉高压。通过连续眼底镜检查和荧光素眼底血管造影对所有动物的高血压眼底变化进行了详细的研究，并对23只眼进行了病理学检查。高血压性视神经病变的最初证据是视盘水肿，在中位血压（BP）为190 mmHg（正常BP，120 mmHg）时发生。随访时，视盘出现轻度至明显苍白。视盘改变与血压及其他眼底改变相关。高血压性视神经病变的发病机制，这一直是极具争议的，到目前为止，讨论长度在本研究的结果和其他最近的证据。本研究中所有可用的临床和病理结果表明，高血压性视神经病变是前部缺血性视神经病变的一种形式，而高血压性视神经病变是一个独特的实体。对于高血压视神经病变患者，应注意血压的急剧下降，因为这可能导致完全的永久性失明。
We produced experimental renovascular arterial hypertension in 57 rhesus monkeys by modified Goldblatt's procedures. Hypertensive fundus changes were studied in detail by serial ophthalmoscopy and fluorescein fundus angiography in all animals on a long-term follow-up, and pathologically in 23 eyes. Initial evidence of hypertensive optic neuropathy was optic disc edema which developed at the median blood pressure (BP) of 190 mmHg (normal BP, 120 mmHg). On follow-up, mild to marked pallor of the optic disc developed. The optic disc changes were correlated with BP and other fundus changes. Pathogenesis of hypertensive optic neuropathy, which has been highly controversial so far, is discussed at length in the light of the findings of the present study and other recent evidence. All the available clinical and pathologic findings in the present study indicate that hypertensive optic neuropathy represents a form of anterior ischemic optic neuropathy, and that hypertensive optic neuropathy is a distinct entity. A caution is given against a precipitous reduction of BP in patients with hypertensive optic neuropathy because that may cause complete, permanent blindness.