Nonarteritic Anterior Ischemic Optic Neuropathy Of Clinical Characteristics In Diabetic Patients Versus Nondiabetic Patients

Objective:To investigate various aspects of anterior ischemic optic neuropathy (AION) in patients with diabetes mellitus and to compare them with those in patients without diabetes mellitus.Methods:The clinical data of32patients(46eyes) who were diagnosed as AION were collected from Ophthalomology department of Dalian medical university fist affiliated hospital.Retrospectively the clinical data of patients with diabetes and nondiabetes: include the patient’s gender,age,history of systemic disease,Visual, intraocular pressure, anterior segment examination and fundus examination, fundus color photography, fundus fluorescein angiography (FFA)and visual field examination,whether there are differences.Results:A total of32patients with AION (46eyes), male14cases20eyes,18eyes of26cases of female,The average age of (60±12.9) years old, including13patients with hypertension (41%),7(22%) of patients with coronary heart disease, hyperlipidemia,3people (9%), cerebrovascular disease (12.5%)4. Diabetes mellitus group12eyes of22cases, the average age was (60±13.1) years old,6patients with hypertension (50%),3(25%) of patients with coronary heart disease, hyperlipemia in2(17%), cerebrovascular disease (8%)1. Non diabetic group of20eyes of24patients, mean age (60±12.8) years old,7patients with hypertension (35%),4(20%) of patients with coronary heart disease, hyperlipemia in2(10%), cerebrovascular disease (10%)2. Two sets of data were analyzed by chi square analysis after age, hypertension, coronary heart disease, cerebrovascular disease, P<0.05, statistically significant differences.46eyes mean IOP (15.8±3.9) mmHg,The average IOP of diabetic group was (15.6±3.7) mmHg, The average IOP of non-diabetic group was (15.9±4.1) mmHg, statistical results show that, there is no difference (P>0.05)between them.In this study, diabetic patients have different degree of DR.3cases of diabetic patients with AION (13,.6%),9patients in stage II diabetes patients with AION (40.9%),6patients with stage III AION patients with diabetes mellitus (27.3%),3cases in stage IV diabetic patients with AION (13.6%), 1cases of diabetic patients with AION stage V (4.5%). FFA test results:all patients with FFA were examined by early selection showed delayed filling of the optic disc, disc boundary is not clear, the edge of optic disc in diabetic AION small bleeding blocked fluorescence in7eyes,5eyes with non diabetic patients; patients with advanced diabetic AION is full of disc strong fluorescence in16eyes, part of the optic disc strong fluorescence in6eyes non diabetes, AION advanced all wheel strong fluorescence in10eyes,12eyes of hyper fluorescence. Macular edema in diabetic patients17eyes,1eyes of only non diabetics, retinal non perfusion area, diabetic patients15eyes. Visual field examination:non-diabetic group vision appeared arched dark area, and is connected with the physiological blind spot in15eyes, half visual field defects in4eyes, below, nasal visual field defects in1cases, temporal visual field defects in3eyes. FFA image and visual field defect basically shows the correspondence between the18eyes,6eyes showed no relationship. Diabetic group was2cases (3eyes) patients can not check, the result is lack of reliability. The typical visual field change in3eyes, the lower visual field defect in3eyes,4eyes of temporal nasal side,3eyes,4eyes of concentric contraction. FFA image and visual field defect is the correspondence between the2eyes,20eyes showed no relationship,Conclusions:1diabetes AION relative to non diabetes population have dilinghua trend. Coronary heart disease in hypertension, non diabetes population, the incidence of cerebrovascular diseases is higher. In the period..2. AION could appear in the any stage of diabetic retinopathy(DR).In our study, The morbidity of AION in non proliferative diabetic retinopathy is higher than proliferative diabetic retinopathy,But whether DR effect AION and how much influence there are depend on further research on AION.3.Visual field examination of AION is lack of specificity in patients with diabetes mellitus.AION,DR and Macular edema are all play an important role. In nondiabetic patients with AION visual acuity and visual field examination has consistency. In the diagnosis of optic neuropathy in patients with diabetes mellitus should depend on the results of FFA.