Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the Ischemic Optic Neuropathy Decompression Trial.
Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the Ischemic Optic Neuropathy Decompression Trial.
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符合缺血性视神经病变减压试验资格的非动脉炎性前部缺血性视神经病变患者的特征。
DOI：
10.1001/archopht.1996.01100140566007
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发表时间：
1996
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目的描述缺血性视神经病变减压试验患者的临床特征。设计：该试验是一项单掩蔽、多中心、随机的临床试验。设置25个美国临床中心。患者随机分为视神经鞘减压术或仔细随访的标准包括：诊断为急性单侧非动脉炎性前部缺血性视神经病变，视力为20/或更差且优于无光感，年龄50岁或以上。除视力在20/以上者外，其余符合条件的患者均未随机入组，但均进行了随访。结果在420名NAION患者中，258名患者被随机分组，162名未随机分组，正在接受随访。62%的患者是男性，95%是白人。平均发病年龄为66.0±8.7岁。在IONDT中，47%的患者报告有高血压，24%的患者有糖尿病。42%的患者回忆起视觉症状是在觉醒后2小时内。研究眼的初始视力从20/20或更好到光感，49%的患者视力超过20/，34%的患者视力20/200或更差。平均韦氏沉降率为18.4 mm/h，9%的患者的沉降速率大于40 mm/h。未随机分组的患者(视力>20/)较年轻，72%为男性，他们的高血压和糖尿病患病率较低。结论尽管我们的基线结果来自于有资格接受IONDT的NAION患者中的选定人群，但它们提供了一项大型前瞻性研究对NAION的首次描述，该研究使用NAION的标准定义，仅包括在症状出现后2周内被确定的患者。
ObjectiveTo describe the baseline clinical characteristics of patients in the Ischemic Optic Neuropathy Decompression Trial (IONDT).DesignThe IONDT is a single-masked, multicenter, randomized clinical trial.SettingsTwenty-five US clinical centers.PatientsEligibility criteria for randomization to either optic nerve sheath decompression surgery or careful follow-up included a diagnosis of acute unilateral non-arteritic anterior ischemic optic neuropathy (NAION), a visual acuity of 20/64 or worse and better than no light perception, and an age of 50 years or older. Patients who were eligible except for having visual acuity better than 20/64 were not randomized, but were followed up.MethodsEach patient underwent a standardized history and examination by certified study personnel within 14 days of the onset of symptoms. Masked personnel performed outcome measurements.ResultsOf 420 patients with NAION, 258 were randomized, and 162 were not randomized and are being followed up. Sixty-two percent of the patients were men and 95% were white. The mean±SD age at onset was 66.0±8.7 years. Hypertension was reported in 47% of the patients in the IONDT, and 24% of the patients had diabetes mellitus. Forty-two percent of the patients recalled the onset of visual symptoms to be within 2 hours of awakening. Initial visual acuities in the study eye ranged from 20/20 or better to light perception, with 49% of the patients seeing better than 20/64 and 34% of the patients seeing 20/200 or worse. The mean Westergren sedimentation rate was 18.4 mm/h, with 9% of the patients having a rate greater than 40 mm/h. The nonrandomized patients (visual acuity better than 20/64) were younger, 72% were male, and they had a lower prevalence of hypertension and diabetes mellitus.ConclusionAlthough our baseline findings are derived from a selected population of patients with NAION who were eligible for the IONDT, they provide the first description of NAION from a large prospective study that used a standard definition of NAION and only included patients who were identified within 2 weeks of the onset of symptoms.