Abstract：
Anterior ischaemic optic neuropathies (AIONs) are a common cause of permanent visual loss in the elderly population. The non-arteritic subtype has been intensively studied. While systemic associations such as hypertension and diabetes mellitus are commonly recognized and treated, others such as obstructive sleep apnoea (OSA) are largely overlooked in daily practice. A 60-year-old man who gave no history of any systemic illness presented to us 1 week following an uneventful cataract surgery with posterior chamber intraocular lens implantation in his right eye. The surgery was performed elsewhere by an eye-healthcare professional where the patient presented primarily with a history of progressively worsening diminution of vision in the same eye for 5 days and was diagnosed with a senile cataract. The postoperative visual gain was unsatisfactory; hence he sought another opinion. A diagnosis of non-arteritic AION (NAION) was established. Systemic evaluation revealed elevated diastolic blood pressure, dyslipidaemia and severe OSA. Prompt treatment with systemic steroids and simultaneous management of the accompanying systemic morbid conditions saved some useful vision in the affected eye. This also prevented involvement of the fellow unaffected eye. A comprehensive ocular examination with emphasis on systemic evaluation of the patient for coexisting illness is imperative before proceeding with any medical or surgical intervention. OSA is a definitive risk factor for the development of NAION, though it remains underdiagnosed and untreated. Cataract surgery has been shown to worsen underlying NAION. Systemic stabilization averts potentially blinding sequel in the unaffected eye of these patients.
摘要：
前部缺血性视神经病变（AIONs）是老年人永久性视力丧失的常见原因。非动脉炎亚型已被深入研究。虽然高血压和糖尿病等全身性关联通常得到认可和治疗，在日常实践中，阻塞性睡眠呼吸暂停（OSA）等其他疾病在很大程度上被忽视。一名60岁的男子，他没有任何全身性疾病的病史，在他的右眼进行后房型人工晶状体植入的白内障手术后1周出现在我们面前。手术是由眼科保健专业人员在其他地方进行的，该患者主要表现为同一只眼睛视力逐渐恶化5天的病史，并被诊断出患有老年性白内障。术后视力增益不令人满意；因此他寻求另一种意见。建立了非动脉炎AION（NAION）的诊断。系统评估显示舒张压升高，血脂异常和严重OSA。全身性类固醇的及时治疗和伴随的全身性病态的同时治疗在受影响的眼睛中节省了一些有用的视力。这也防止了未受影响的眼睛的参与。在进行任何医疗或手术干预之前，必须进行全面的眼部检查，重点是对患者的共存疾病进行系统评估。OSA是NAION发展的决定性风险因素，尽管它仍然未被诊断和治疗。白内障手术已被证明会使基础NAION恶化。全身稳定可避免这些患者未受影响的眼睛中潜在的致盲后遗症。
