摘要
目的初步探讨临界闪烁融合频率(CFF)在非动脉炎性前部缺血性视神经病变(NAION)中的应用价值。方法横断面研究。2021年1~9月于解放军总医院第一医学中心眼科检查确诊的NAION患者58例105只眼(NAION组)和同期健康对照者33名63只眼(HC组)纳入研究。受检者行最佳矫正视力(BCVA)、光相干断层扫描(OCT)、视野、CFF、闪光视觉诱发电位(F-VEP)检查。采用Snellen小数视力表行BCVA检查,统计时换算为最小分辨角对数视力。NAION组56例72只眼,包括男性31例43只眼,女性25例29只眼;平均年龄(49.28±11.42)岁。按照发病至行CFF检查的时间间隔,将发病时间分为<1、1~<3、3~<6、>6个月,分别为20(27.8%)、26(36.1%)、17(23.6%)、9(12.5%)只眼。按照CFF检查时BCVA≥0.5、0.1~0.5、<0.1将NAION分为轻度、中度、重度,分别为33(45.8%)、32(44.4%)、7(9.8%)只眼。HC组33例63只眼,包括男性17例31只眼,女性16例32只眼;平均年龄(35.18±10.96)岁。采用日本NEITZ公司手持式CFF检测仪2型行CFF检查。记录CFF检查1周内受检眼视盘周围视网膜神经纤维层(pRNFL)厚度、黄斑内界膜至视网膜色素上皮层(mILM-RPE)厚度、F-VEP峰时和峰值、视野平均缺损(MD)值。不同检查时间点和不同程度NAION患眼CFF值比较行单因素方差分析。采用Pearson相关性分析法分析CFF与F-VEP峰时、峰值、BCVA和视野MD值的相关性。结果NAION组患眼CFF-红色、绿色、黄色值分别(22.56±10.30)、(24.10±11.51)、(24.81±11.41)Hz。与HC组比较,NAION组患眼CFF-红色、绿色、黄色值均明显减低,差异均有统计学意义(t=-10.53、-11.11、-11.36,P<0.05)。发病后不同时间点CFF-红色、绿色、黄色值比较,差异无统计学意义(F=2.075、1.893、2.073,P>0.05);不同程度NAION患眼CFF-红色、绿色、黄色值比较,差异有统计学意义(F=31.579、27.332、32.055,P<0.05)。相关性分析结果显示,患眼F-VEP峰时(r=-0.362、-0.379、-0.357,P<0.05)、BCVA(r=-0.705、-0.695、-0.714,P<0.05)与CFF三色呈负相关,MD与CFF三色呈正相关(r=0.486、0.435、0.450,P<0.05)。结论NAION患眼CFF值明显降低;较F-VEP可更为敏感地反映NAION患者视力损伤情况,且与视功能及F-VEP峰时存在较好的相关关系。
Objective To investigate the application of critical flicker fusion frequency(CFF)in non-arteritic anterior ischemic optic neuropathy(NAION).Methods A cross-sectional study.From January 2021 to September 2021,a total of 58 NAION patients(105 eyes)(NAION group)and 33 cases(63 eyes)in the healthy control(HC)group were included from Department of Ophthalmology of First Medical Center,PLA General Hospital.Patients underwent best-corrected visual acuity(BCVA),optical coherence tomography(OCT),visual field,CFF and flash visual evoked potential(F-VEP)examinations.BCVA examination was performed using a Snellen decimal visual acuity chart and was converted to logarithm of the minimum angle of resolution visual acuity.In the affected eyes group,there were 56 cases(72 eyes),31 cases(43 eyes)male and 25 cases(29 eyes)female,with an average age of 49.28±11.42 years old.And the affected eyes were divided into 4 groups:<1,1-<3,3-<6 and>6 months according to the time interval from onset to CFF examination,which were 20(27.8%),26(36.1%),17(23.6%)and 9(12.5%)eyes,respectively.According to the BCVA≥0.5,0.1-0.5,<0.1 in CFF examination,the affected eyes were divided into a mild,moderate,and severe degree,33(45.8%),32(44.4%)and 7(9.8%)eyes,respectively.Sixty-three eyes of 33 cases were in the HC group.There were 17 cases(31 eyes)males and 16 cases(32 eyes)females,with an average age of 35.18±10.96 years.Hand-held CFF detector type 2(Japan,NEITZ company)was used for the CFF examination.The thickness of peripheral retinal nerve fiber layer(pRNFL),macular inner limiting membrane retinal pigment epithelium(mILM-RPE),F-VEP peak time and peak value and mean visual field defect(MD)values were recorded within 1 week of CFF examination.The CFF value of the above subgroups was analyzed in order using one-way ANOVA.Pearson correlation analysis was used for the correlation between CFF and F-VEP peak time,peak value,BCVA and MD.The correlations between BCVA,visual field,F-VEP,and CFF were analyzed.Results The trichromatic values of red,green and yellow in NAION affected eyes were 22.56±10.30,24.10±11.51,24.81±11.41 Hz,respectively,which was significantly reduced compared with the HC group(t=-10.53,-11.11,-11.36;P<0.05).There was no significant difference in CFF-red,green,and yellow values at different time points after the onset of the disease(F=2.075,1.893,2.073;P>0.05).Compared CFF-red,green,and yellow values in NAION-affected eyes with different degrees,the difference was statistically significant(F=31.579,27.332,32.055;P<0.05).The results of correlation analysis showed that the peak time of F-VEP(r=-0.362,-0.379,-0.357;P<0.05),BCVA(r=-0.705,-0.695,-0.714;P<0.05),and which was negatively correlated with CFF three color.MD and CFF were positively correlated(r=0.486,0.435,0.450;P<0.05).Conclusion The CFF value of the affected eye is decreased significantly in NAION-affected eyes,and CFF is more sensitive than F-VEP in reflecting visual impairment,and has a good correlation with visual function and latency of F-VEP.
作者
付俊霞
李晓明
王永平
周欢粉
徐全刚
魏世辉
Fu Junxia;Li Xiaoming;Wang Yongping;Zhou Huanfen;Xu Quangang;Wei Shihui(Department of Ophthalmology,The Chinese People’s Liberation Army General Hospital&The Chinese People’s Liberation Army Medical School,Beijing 100853,China;the Department of Ophthalmology,Jilin Province People's Hospital,Changchun 130021,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第10期769-774,共6页
Chinese Journal of Ocular Fundus Diseases
关键词
视神经病变
缺血性
临界闪烁融合频率
Optic neuropathy,ischemic
Critical flicker fusion frequency
