Klinička i ultrasonografska obeležja prednje ishemičke optičke neuropatije

  • Dragos Cătălin Jianu University of Medicine and Pharmacy, Department of Neurology, Timisoara, Romania
  • Silviana Nina Jianu University of Medicine and Pharmacy, Department of Ophthalmology, Timisoara, Romania
  • Mihnea Munteanu University of Medicine and Pharmacy, Department of Ophthalmology, Timisoara, Romania
  • Ligia Petrica University of Medicine and Pharmacy, Department of Internal Medicine-Nephrology, “Victor Babes” Timisoara, Romania
DOI: https://doi.org/10.2298/VSP150810356J
Ključne reči: neuropatija, optička, ishemička;, faktori rizika;, arteritis, temporalni;, dijagnoza, diferencijalna;, ultrasonografija, dopler, kolor.

Sažetak


Uvod/Cilj. Prednja ishemička optička neuropatija (AION) predstavlja segmentni infarkt papile optičkog ner­va vaskularizovanog preko posteriorne cilijarne arterije. Postoje dva tipa AION: arterijska (A-AION), koja je gotovo bez izuzetka, posledica arteritisa dzinovskih ćelija (GCA) i nearterijska (NA-AION). Cilj rada je bio da se istraže kli­ni­čka i ultrazvučna obeležja  orbitalnih krvnih sudova, temporalne superficijalne arterije i karotidnih arterija, koja bi bila od pomoći u diferencijalnoj dijagnostici akutne AION. Metode. Prospektivnom, uporednom opservacionom stu­dijom obuhvacena su 62 uzastopna bolesnika sa sumnjom na jednostranu akutnu AION, koji su bili ispitani prilikom prijema i tokom prva dva meseca evolucije bolesti prema protokolu koji je uključivao kolor dopler snimanje orbitalnih krvnih sudova. Rezultati. Kod 12 bolesnika je usta­novljena i biopsijom potvrđena A-AION, dok je kod 50 bolesnika ustanovljena NA-AION. Kod bolesnika sa A-AION bolest se manifestovala prisustvom amaurosis fugax pre pojave akutnog, bezbolnog gubitka vida teškog stepena u zahvaćenom oku i difuznim bledim edemom optičkog diska. Kolor doplerom orbitalnih krvnih sudova ustanov­ljen je ozbiljno smanjen protok krvi u posteriornim cilijarnim arterijama izraženiji na zahvaćenoj strani i praćen visokim indeksom rezistencije (IR) u svim retrobulbarnim krvnim sudovima obe orbite. Kod bolesnika sa NA-AION kolor doplerom nisu registrovane opisane promene. Ti­pič­no ultrazvučno obeležje u temporalnom arteritisu, kao de­lu GCA, bio je „dark halo“ znak. Zaključak. Ultrazvučno ispitivanje omogućava postavljanje brze diferencijalne dijagnoze između A-AION /NA-AION kod bolesnika sa akutnom AION.

Reference

References

Biousse V, Newman NJ. Ischemic Optic Neuropathies. N Engl J Med 2015; 372(25): 2428‒36.

Hayreh SS. Ischemic optic neuropathies-where are we now?. Graefes Arch Clin Exp Ophthalmol 2013; 251(8): 1873‒84.

Hayreh SS. Ischaemic optic neuropathy. Indian J Ophthal¬mol 2000; 48(3): 171‒94.

Hayreh SS. Management of ischemic optic neuropathies. In-dian J Ophthalmol 2011; 59(2): 123‒36.

Arnold AC. Ischemic optic neuropathy. In: Ianoff M, Duker JS, editors. Ophtalmology. 2nd ed. . St. Louis: Mosby; 2004. p. 1268‒72

Collignon-Robe NJ, Feke GT, Rizzo JF 3rd. Optic nerve head circulation in nonarteritic anterior ischemic optic neuropathy and optic neuritis. Ophthalmology 2004; 111(9): 1663‒72.

Gonzalez-Gay MA, Garcia-Porrua C, Llorca J, Hajeer AH, Branas F, Dababneh A. Visual manifestations of giant cell arteritis: Trends and clinical spectrum in 161 patients. Medicine (Balti-more) 2000; 79(5): 283‒92.

Martínez-Valle F, Solans-Laqué R, Bosch-Gil J, Vilardell-Tar¬rés M. Aortic involvement in giant cell arteritis. Autoim¬mun Rev 2010; 9(7): 521‒4.

Beck RW, Servais GE, Hayreh SS. Anterior ischemic optic neu-ropathy. IX. Cup-to-disc ratio and its role in patho¬genesis. Ophthalmology 1987; 94(11): 1503‒8.

Jianu DC, Jianu SN, Petrica L, Muresanu DF, Popescu BO, Focsa MA. Anterior ischemic optic neuropathies: clinical and ultra-sonographic characteristics in arteritic versus nonarteritic forms. Am J Neuroprot Neuroreg 2012; 4(2): 154‒62.

Jianu DC, Jianu SN, Petrica L. Color Doppler imaging of retro-bulbar vessels findings in large giant cell arteritis with eye in-volvement. J US China Med Sci 2011; 8(2): 99–108.

Jianu DC, Jianu SN. The role of Color Doppler Imaging in the study of optic neurophaties. In: Jianu DC, Jianu SN, editors. Color Doppler Imaging. Neuro-ophthalmological correlations. Timisoara, Romania: Mirton; 2010. p. 154‒74.

Jianu DC, Jianu SN, Petrica L, Serpe M. Large giant cell arteri¬tis with eye involvement. In: Amezcua-Guerra, edi¬tor. Advances in the diagnosis and treatment of vasculitis. Rijeka, Croatia: In-tech; 2011. p. 311‒30.

Jianu DC, Jianu SN. Giant cell arteritis and arteritic ante¬rior ischemic optic neuropathies. In: Sakkas LI, Katsiari C, editors. Updates in the diagnosis and treatment of vascu¬litis. Rijeka, Croatia: Intech; 2013. p. 111‒30.

van Stavern GP, Newman NJ. Opticneuropathies: an over¬view. Ophthalmol Clin North Am 2001; 14(1): 61‒71, viii.

Melson MR, Weyand CM, Newman NJ, Biousse V. The diagno¬sis of giant cell arteritis. Rev Neurol Dis 2007; 4(3): 128‒42.

Singh AG, Kermani TA, Crowson CS, Weyand CM, Matte¬son EL, Warrington KJ. Visual manifestations in giant cell arteritis: Trend over 5 decades in a population-based co¬hort. J Rheumatol 2015; 42(2): 309‒15.

Hayreh SS, Podhajsky PA, Zimmerman B. Occult giant cell arteritis: ocular manifestations. Am J Ophthalmol 1998; 125(4): 521‒6.

Pichot O, Gonzalvez B, Franco A, Mouillon M. Color Dop¬pler ul-trasonography in the study of orbital and ocular vascular dis-eases. J Fr Ophtalmol 1996; 19(1): 19‒31. (French)

Lieb WE, Cohen SM, Merton DA, Shields JA, Mitchell DG, Gold-berg BB. Color Doppler imaging of the eye and orbit. Tech-nique and normal vascular anatomy. Arch Ophthal¬mol 1991; 109(4): 527‒31.

Tranquart F, Aubert-Urena AS, Arsene S, Audrierie C, Ros¬sazza C, Pourcelot L. Echo-Doppler couleur des arteres ciliaires post-erieures dans la neuropathie optique ischemi¬que anterieure ai-gue. JEMU 1997; 18(1): 68‒71.

Gonzalez-Gay MA. The diagnosis and management of pa¬tients with giant cell arteritis. J. Rheumatol 2005; 32(7): 1186‒8.

Hayreh SS, Podhajsky PA, Raman R, Zimmerman B. Giant cell arteritis: validity and reliability of various diagnostic criteria. Am J Ophthalmol 1997; 123(3): 285‒96.

Dasgupta B1, Borg FA, Hassan N, Alexander L, Barraclough K, Bourke B, et al. BSR and BHPR guidelines for the man-agementof giant cell arteritis. Rheumatology (Oxford) 2010; 49(8): 1594‒7.

Hayreh SS, Joos KM, Podhajsky PA, Long CR. Systemic dis¬eases associated with nonarteritic anterior ischemic optic neuropa-thy. Am J Ophthalmol 1994; 118(6): 766‒80.

Schmidt WA, Kraft HE, Vorpahl K, Völker L, Gromnica-Ihle EJ. Color duplex ultrasonography in the diagnosis of tem¬poral ar-teritis. N Engl J Med 1997; 337(19): 1336‒42.

Schmidt WA. Takayasu and temporal arteritis. In: Baumgartner RW, editor. Handbook on Neurovascular Ultrasound. Basel: Karger; 2006; 2: 96‒104.

Objavljeno
2020/12/08
Broj časopisa
Vol. 75 Br. 8 (2018): August Vol. 75 (No. 8)
Rubrika
Originalni članak