Anterior ischemic optic neuropathy. V. Optic disc edema an early sign.
Anterior ischemic optic neuropathy. V. Optic disc edema an early sign.
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作者：
S. Hayreh
4例患者出现双侧前路缺血性视神经病变（AION）。在所有四个病例中，AION都以经典的表现在第一只眼睛中发展。另一只眼有无症状视盘水肿（ODE），最初没有主观或客观视力丧失，但后来出现了典型的AION临床症状。研究结果表明，无症状的ODE可能先于AION的视力丧失，并可能构成该疾病的最早征兆。由于AION中的ODE是由于轴浆血流停滞，其本身不会产生视觉损失（视觉损失是由视觉冲动传输中断造成的），这表明轻度视神经头部缺血干扰了轴浆流而不破坏视觉冲动；然而，更严重的缺血会破坏两者。讨论了不同程度的急性视神经头缺血可能产生的影响。
Four unusual patients had bilateral anterior ischemic optic neuropathy (AION). In all four cases, AION developed in the first eye with the classic presentation. The fellow eye had symptomless optic disc edema (ODE) with no subjective or objective visual loss initially, but the classic AION clinical picture developed later on. The findings indicate that symptomless ODE may precede the visual loss in AION and could constitute the earliest sign of this disease. Since ODE in AION is due to axoplasmic flow stasis that, by itself, does not produce visual loss (this is produced by disruption of visual impulse transmission), this would suggest that mild optic nerve head ischemia interferes with axoplasmic flow without disrupting the visual impulse; however, more severe ischemia would disrupt both. Possible effects of various grades of acute optic nerve head ischemia are discussed.