OCT On Disk Area,Cup Area With Non-arteritic Anterior Ischaemic Optic Neuropathy

Purpose :To investigate the relationship between disk area,cup area and incidence in patients with NAION.And Objective to evaluate two different therapeutic regimens for Non-arteritic anterior ischaemic optic neuropathy(NAION)at papilloedema stage ,to find out the best option.Methods : Study of the patients with NAION in the Department of Ophthalmology ,XI'AN 4th hospital .All patients correspond to the diagnosis criteria of NAION at edema disappeared stage ,average history≥3 month. divided into Diseased Eyes Group(Group A):66 patients (106 eyes) and Contralateral Eyes Group(Group B) 66 patients (66 eyes) . optical coherence tomography (OCT) examination were performed both of the groups , Measures horizontal and vertical disc and cup diameters, mean values of the vertical diameter and horizontal diameter, and optic disc area, calculation cup depth and . And we classified by cup shape into 4 grades cup: (GradeⅠ:cup bottom above retinal nerve fiber layer(RNFL); GradeⅡ: cup bottom on the same level with RNFL;GradeⅢ:cup bottom between RNFL and choroid; GradeⅣ: cup bottom below choroid). compared between two groups and with normal people norm.Study of two therapeutic effect of 206 patients (218 eyes) with NAION in the Department of Ophthalmology.Diagnosed by optical fundus examination and Optical Coherence Tomography (OCT), with less than 2 weeks of course,and control subjects 31 patients(32 eyes) without Ophthalmology treatment. divided into 3 groups : group A (Western medicine treatment), group B (Combined Chinese and Western Medicine therapy), group C (control group ).Result:RNFL thickness: The difference was statistically significant between Group A and Group B; Both Group are differ with normal people norm(t1= 6.597, P1=0.000;t2 =8.569, P2 =0.000; t4= 7.274, P4=0.000;t5=4.063, P5=0.000; t7=8.020, P7=0.000;t8=10.019, P8=0.000; t10=3.904, P10=0.001;t11=5.642,P11=0.000); but Group B no statistics difference with normal people(t3=0.884, P3=0.387; t6=0.999, P6=0.329; t9=1.387, P9=0.180; t12=0.944, P12=0.356); Group A: GradeⅠ41 eyes(38.68%), GradeⅡ32 eyes( 30.19%),Grade Ⅲ23 eyes( 22.64%),GradeⅣ9 eyes (8.49%);In Group B: GradeⅠ12 eyes (18.18%), GradeⅡ21 eyes (31.82%),GradeⅢ27 eyes( 40.91%),GradeⅣ6 eyes (9.09%); Optic disc area: No difference was statistically significant between Group A and Group B(t13=0.677, P13=0.502; t161.125, P16=0.267; t19=0.565, P19=0.575; t22=1.109, P22=0.274); Both Grop are smaller then normal people norm(t14=3.694, P14=0.001; t15=2.589, P15=0.013; t17=18.343,P17=0.000;t18=3.837, P18=0.000; t20=3.457, P20=0.001;t21=2.086, P21=0.044; t23=19.574,P23=0.000;t24=3.414, P24=0.002); NAION patients eyes with shallow cups or even ignore cups physiological characteristics After edema dissipated, depending Cup narrow still exist.The therapeutic effect of group B have statistically differences to A.All of A and B groups have statistically differences to countrol group. Conclusion: 1.Optic Disk and Cup area in NAION Patients are smaller than that of the normal .2.The cup shape and the Optic Disk and Cup area may play an important role in the pathogenesis of NAION.3. Treatment in NAION edema period is the key to saving patients vision lose 4. Combined Chinese and Western Medicine therapy had a significant efficacy for NAION at papilloedema stage.and less side– effect. Edema period should be cautiously uses in the expansion of microvascular of shallow cups or even ignore cups patients.