视神经-颈动脉减压后意外发现视网膜神经纤维层变薄且进展缓慢1例

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-08 DOI:10.1016/j.ajoc.2025.102376

Hidenori Takahashi , Keisuke Ohtani , Takeshi Hara , Kensuke Kawai

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引用次数: 0

摘要

目的报告一例视神经-颈动脉减压手术后视网膜神经纤维层（NFL）变薄的病例。一位41岁的眼科医生在使用光学相干断层扫描（OCT）时偶然发现左眼NFL普遍变薄。5年前，OCT仅显示轻度变薄。虽然视力和视野正常，但患者报告视力模糊。MRI显示扩张和扭曲的左颈内动脉压迫左视神经。由于缺乏关于NFL厚度与视力相关性的报道，我们进行了内部审查。我们寻找从健康视力发展到失明的病例，在唯一确定的病例中，我们研究了NFL厚度与视力之间的相关性。根据这种相关性，预测患者将在48岁时失去视力。结果，患者决定接受减压手术。手术后，NFL变薄的速度从- 1.9 μm/年显著减缓至- 0.57 μm/年(p <；。)。患者目前48岁，矫正视力为20/16，视野正常。预计失明的发病时间被推迟了10年。结论和重要性：我们报告了一例视网膜神经纤维层（NFL）变薄的患者被颈内动脉压迫视神经的病例。手术减压后，发现NFL变薄的速度减慢。

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Incidental detection of retinal nerve fiber layer thinning with slowed progression following optic nerve-carotid artery decompression: A case report

Purpose

This report aims to present a case of the retinal nerve fiber layer (NFL) thinning, in which the progression of thinning was slowed following optic nerve-carotid artery decompression surgery.

Observations

A 41-year-old ophthalmologist incidentally noticed a generalized thinning of NFL in his left eye using optical coherence tomography (OCT). Five years earlier, the OCT showed only mild thinning. While visual acuity and visual fields were normal, the patient reported a blurriness. The MRI revealed an ectatic and tortuous left internal carotid artery compressing the left optic nerve. Due to the lack of reports on the correlation between NFL thickness and visual acuity, an internal review was conducted. We searched for cases with a progression from healthy visual acuity to blindness, and in the only case identified, we investigated the correlation between NFL thickness and visual acuity. Applying this correlation, it was predicted that the patient would lose vision by age 48. As a result, the patient decided to receive decompression surgery. Following the surgery, the rate of NFL thinning significantly slowed from −1.9 μm/year to −0.57 μm/year (p < .0001). At the current age of 48, the patient's corrected visual acuity is 20/16, and visual field remains normal. The predicted onset of blindness has been postponed by 10 years.

Conclusions and importance

We report a case in which compression of the optic nerve by the internal carotid artery was observed in a patient with retinal nerve fiber layer (NFL) thinning. A slowing of NFL thinning was noted following surgical decompression.

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.