Ahmet M Hondur, Golnaz Moazami, Gozde Hondur, Tongalp H Tezel
{"title":"非动脉炎性缺血性视神经病变与健康眼的玻璃体毛细血管发现：临床与 OCT 比较。","authors":"Ahmet M Hondur, Golnaz Moazami, Gozde Hondur, Tongalp H Tezel","doi":"10.1016/j.ophtha.2024.09.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Participants and controls: </strong>Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).</p><p><strong>Methods: </strong>The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).</p><p><strong>Main outcome measures: </strong>The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.</p><p><strong>Results: </strong>The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.</p><p><strong>Conclusions: </strong>Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.</p>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":" ","pages":""},"PeriodicalIF":13.1000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison.\",\"authors\":\"Ahmet M Hondur, Golnaz Moazami, Gozde Hondur, Tongalp H Tezel\",\"doi\":\"10.1016/j.ophtha.2024.09.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.</p><p><strong>Design: </strong>Case-control study.</p><p><strong>Participants and controls: </strong>Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).</p><p><strong>Methods: </strong>The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).</p><p><strong>Main outcome measures: </strong>The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.</p><p><strong>Results: </strong>The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.</p><p><strong>Conclusions: </strong>Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.</p><p><strong>Financial disclosure(s): </strong>Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.</p>\",\"PeriodicalId\":19533,\"journal\":{\"name\":\"Ophthalmology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":13.1000,\"publicationDate\":\"2024-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ophtha.2024.09.008\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ophtha.2024.09.008","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Vitreopapillary Findings in Nonarteritic Ischemic Optic Neuropathy versus Healthy Eyes: A Clinical and OCT Comparison.
Purpose: To study the vitreopapillary interface in nonarteritic ischemic optic neuropathy (NAION) for features that may predispose to optic nerve perfusion defects.
Design: Case-control study.
Participants and controls: Patients with NAION (study group) were compared with healthy non-NAION patients with crowded discs (control group I) and noncrowded optic discs (control group II).
Methods: The vitreopapillary interface was studied in 32 eyes with NAION using high-resolution OCT scans. Results were compared with 2 control groups consisting of age, sex, and refraction-matched non-NAION individuals with crowded optic discs (control group I: 31 eyes) and noncrowded optic discs (control group II: 32 eyes).
Main outcome measures: The incidence of total posterior vitreous detachment (PVD), vitreopapillary and vitreovascular attachments, and epipapillary membranes.
Results: The rate of PVD over the macula was similar between groups (NAION: 62.5%, control I: 61.3%, and control II: 65.6%, P = 0.93), whereas the posterior hyaloid remained attached to the crowded discs at a significantly higher rate (NAION: 81.2%, control I: 83.9% and control II: 43.7%, P = 0.0005). A higher rate of focal vitreopapillary attachments on crowded discs than on noncrowded discs was noted (NAION: 72.2%, crowded control I: 58.7%, and noncrowded control II: 19.1%, P = 0.007). Vitreovascular attachments (NAION: 68.8%, crowded control I: 3.2% vs. noncrowded control II: 6.3%, P = 0.00001) and dense epipapillary membranes were observed in NAION eyes.
Conclusions: Crowded discs may have stronger vitreopapillary attachments. A close relationship of these attachments with optic nerve vessels may lead to the transmission of strong tractional forces by a syneretic vitreous gel, especially after macular PVD. This transduced mechanical force may contort the vessel wall and disrupt the blood flow in NAION.
Financial disclosure(s): Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article.
期刊介绍：
The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.
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