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Abstract：
OBJECTIVE: To evaluate the role of papillary vitreous detachment in the pathogenesis of non-arteritic anterior ischaemic optic neuropathy (NAION) by comparing the features of vitreopapillary interface between NAION patients and normal individuals.
METHODS: This study included 22 acute NAION patients (25 eyes), 21 non-acute NAION patients (23 eyes) and 23 normal individuals (34 eyes). All study participants underwent swept-source optical coherence tomography to assess the vitreopapillary interface, peripapillary wrinkles and peripapillary superficial vessel protrusion. The statistical correlations between peripapillary superficial vessel protrusion measurements and NAION were analysed. Two NAION patients underwent standard pars plana vitrectomy.
RESULTS: Incomplete papillary vitreous detachment was noted in all acute NAION patients. The prevalence of peripapillary wrinkles was 68% (17/25), 30% (7/23) and 0% (0/34), and the prevalence of peripapillary superficial vessel protrusion was 44% (11/25), 91% (21/23) and 0% (0/34) in the acute, non-acute NAION and control groups, respectively. The prevalence of peripapillary superficial vessel protrusion was 88.9% in the eyes without retinal nerve fibre layer thinning. Furthermore, the number of peripapillary superficial vessel protrusions in the superior quadrant was significantly higher than that in the other quadrants in eyes with NAION, consistent with the more damaged visual field defect regions. Peripapillary wrinkles and visual field defects in two patients with NAION were significantly attenuated within 1 week and 1 month after the release of vitreous connections, respectively.
CONCLUSIONS: Peripapillary wrinkles and superficial vessel protrusion may be signs of papillary vitreous detachment-related traction in NAION. Papillary vitreous detachment may play an important role in NAION pathogenesis.
METHODS: This study included 22 acute NAION patients (25 eyes), 21 non-acute NAION patients (23 eyes) and 23 normal individuals (34 eyes). All study participants underwent swept-source optical coherence tomography to assess the vitreopapillary interface, peripapillary wrinkles and peripapillary superficial vessel protrusion. The statistical correlations between peripapillary superficial vessel protrusion measurements and NAION were analysed. Two NAION patients underwent standard pars plana vitrectomy.
RESULTS: Incomplete papillary vitreous detachment was noted in all acute NAION patients. The prevalence of peripapillary wrinkles was 68% (17/25), 30% (7/23) and 0% (0/34), and the prevalence of peripapillary superficial vessel protrusion was 44% (11/25), 91% (21/23) and 0% (0/34) in the acute, non-acute NAION and control groups, respectively. The prevalence of peripapillary superficial vessel protrusion was 88.9% in the eyes without retinal nerve fibre layer thinning. Furthermore, the number of peripapillary superficial vessel protrusions in the superior quadrant was significantly higher than that in the other quadrants in eyes with NAION, consistent with the more damaged visual field defect regions. Peripapillary wrinkles and visual field defects in two patients with NAION were significantly attenuated within 1 week and 1 month after the release of vitreous connections, respectively.
CONCLUSIONS: Peripapillary wrinkles and superficial vessel protrusion may be signs of papillary vitreous detachment-related traction in NAION. Papillary vitreous detachment may play an important role in NAION pathogenesis.
摘要：
目的：通过比较非动脉炎性前部缺血性视神经病变（NAION）患者与正常人的玻璃体乳头界面特征，探讨玻璃体脱离在NAION发病机制中的作用。
方法：本研究包括22例急性NAION患者（25只眼），21例非急性NAION患者（23只眼）和23例正常人（34只眼）。所有研究参与者都接受了扫频源光学相干断层扫描，以评估玻璃体乳头界面。乳头周围皱纹和乳头周围浅表血管突出。分析了乳头周围浅表血管突起测量值与NAION之间的统计相关性。两名NAION患者接受了标准的平坦部玻璃体切除术。
结果：在所有急性NAION患者中均发现不完全乳头状玻璃体脱离。乳头周围皱纹的患病率为68％（17/25），30%(7/23)和0%(0/34)，乳头状周围浅表血管突出的患病率为44％（11/25），91%(21/23)和0%(0/34)的急性，非急性NAION和对照组，分别。在没有视网膜神经纤维层变薄的眼睛中，乳头状周围浅表血管突出的患病率为88.9％。此外，NAION眼的上象限的乳头周围浅表血管突起的数量明显高于其他象限，与更受损的视野缺陷区域一致。两名NAION患者的乳头周围皱纹和视野缺损在玻璃体连接释放后1周和1个月内明显减弱，分别。
结论：乳头周围皱纹和浅表血管突出可能是NAION患者乳头玻璃体脱离相关牵引的征象。乳头状玻璃体脱离可能在NAION的发病机制中起重要作用。
方法：本研究包括22例急性NAION患者（25只眼），21例非急性NAION患者（23只眼）和23例正常人（34只眼）。所有研究参与者都接受了扫频源光学相干断层扫描，以评估玻璃体乳头界面。乳头周围皱纹和乳头周围浅表血管突出。分析了乳头周围浅表血管突起测量值与NAION之间的统计相关性。两名NAION患者接受了标准的平坦部玻璃体切除术。
结果：在所有急性NAION患者中均发现不完全乳头状玻璃体脱离。乳头周围皱纹的患病率为68％（17/25），30%(7/23)和0%(0/34)，乳头状周围浅表血管突出的患病率为44％（11/25），91%(21/23)和0%(0/34)的急性，非急性NAION和对照组，分别。在没有视网膜神经纤维层变薄的眼睛中，乳头状周围浅表血管突出的患病率为88.9％。此外，NAION眼的上象限的乳头周围浅表血管突起的数量明显高于其他象限，与更受损的视野缺陷区域一致。两名NAION患者的乳头周围皱纹和视野缺损在玻璃体连接释放后1周和1个月内明显减弱，分别。
结论：乳头周围皱纹和浅表血管突出可能是NAION患者乳头玻璃体脱离相关牵引的征象。乳头状玻璃体脱离可能在NAION的发病机制中起重要作用。
