【摘要】 目的 观察分析23例（35眼）急性前部缺血性视神经病变的眼底荧光造影（FFA）图像表现特点。方法 收集本院做过FFA检查的视盘水肿病例分为两组进行回顾性、对比性分析。Ⅰ组为确诊急性前部缺血性视神经病变患者，Ⅱ组包括急性视乳头炎、视乳头水肿、视盘血管炎的视盘水肿患者。结合视野检查，部分患者做头颅CT或MR检查。重点关注Ⅰ组急性前部缺血性视神经病变病例。结果 （1）FFA资料:Ⅰ组病例35眼（100%）在造影早期视盘均呈弱荧光，造影后期视盘呈强荧光或强弱荧光不对称，形态比较复杂。视盘荧光染料渗漏显现时间Ⅰ组（静脉期后20～45s）较Ⅱ组（动脉早期10～20s）明显延长。经统计学处理，差异有显著性（P<0.05）。造影早期视盘周脉络膜弱荧光28眼，两组发生比率差异有非常显著性（P<0.01）。（2）视野资料:26眼视野检查，20眼荧光图像与视野缺损呈对应关系，3例未出现相应现象，3例出现相反现象。其中下部半盲5眼，扇型或象限性缺损21眼。结论 造影早期视盘呈弱荧光，造影后期视盘呈强荧光或强弱不对称是急性前部缺血性视神经病变的FFA图像特征。FFA检查对急性前部缺血性视神经病变有较高诊断价值，结合病史、症状、视野检查常能获得早期的诊断。

　　关键词 急性前部缺血性视神经病变 眼底荧光造影 视盘水肿

　　The characteristics of fundus fluorescein angiography  of acute anterior ischemic optic neuropathy   Feng Qifang，Chen Zhenqian，Guo Luping.

    Department of Ophthalmology，the Second Affiliated Hospital  of Guangzhou Medical College，Guangzhou510260.

　　【Abstract】 Objective To investigate the characteristics of fundus fluorescein angiography（FFA）of acute anteˉrior ischemic optic neuropathy（AAION）.Methods The FFA pictures of the eyes with optic disc edema were divided inˉto two groups and were analyzed retrospectively.The patients of group I were diagnosed as AAION and those of group II who had optic edema were acute papillitis，papilloedema and optic vasculitis.With visual field examination，some of the patients had undergone skull CT and MR.Results （1）FFA data:35eyes of group I displayed faint fluorescence at the early stage and strong fluorescence or asymmetrical fluorescence with complex patterns at the later stage.Fluorescein effuˉsion time of optic disc of group I were20～25seconds at vein stage，significantly longer then that of groupⅡwith10～20seconds at early artery stage.The different of the two groups was significant（P<0.05）.28eyes had faint choroids-fluorescence around optic disc at early stage and the incidences of the two groups were significantly different（P<0.01）.（2）The data of visual field:Amony26eyes with visual field examination，20had corresponding relations between the FFA patterns and visual defects，the other3had no，still other3had contrary relation.And five had inferior hemianopsia，the other21had sector defects or tetartanopia.Conclusion The characteristics of FFA patterns of AAION are as follow:faint fluorescence at early stage and strong fluorescence or asymmetrical fluorescence at the later stage.FFA examination has significant diagnose value for AAION.Combined with case history，symptom and visual field examination，early diagnoses can be made.

    Key words acute anterior ischemic optic neuropathy fundus fluorescein angiography edema of optic disc
 
　　急性前部缺血性视神经病变是一种多病因性的严重疾患，是视盘血流中断的结果，可导致视功能的不可逆性破坏。眼底荧光血管造影（FFA）结合视野检查，能较准确协助诊断及了解病情程度，对其治疗及预后有着重要的临床意义。下面是我们对23例35眼的急性缺血性视神经病变患者资料的回顾性分析。

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