Correlation Between RAPD Detection And Visual Function And Syndrome Scores In NAION Patients

Relative Afferent Pupillary Defect(RAPD)reflects the information of the visual function that can't be controlled by individuals.It can Provide the basis of etiological diagnosis and play a certain role as a guideline to diagnose the development of the disease.But there are few studies about RAPD in the domestic.the forming principle of RAPD is coming from the asymmetry of both eyes' optic nerve afferent signals.The purpose of this paper is to attempt to prove the correlation between RAPD and visual functional difference and the integral of TCM syndrome.This thesis mainly includes literature review and clinical research analysis.Literature review includes three parts:"the modern research overview of relative afferent pupillary defect(RAPD)","the modern research achievements of Non-arteritic Anterior Ischaemic Optic Neuropathy(NAION)" and "the traditional Chinese medicine overview of qingmang"."The modern research overview of relative afferent pupillary defect(RAPD)"introduces its definition,principle,measuring method,related disease,and some studies about the correlation between visual function and RAPD In the domesticat and abroad."The modern research achievements of Non-arteritic Anterior Ischaemic Optic Neuropathy(NAION)" introduces its pathogenesis,risk factors and related inspection,treatment and prognosis;"The traditional Chinese medicine overview of qingmang"introduces its definition,dialectical classification,dialectical treatment and special treatment.Clinical research analysis part:objective:to study the correlation between the value of RAPD and visual functional difference and the integral of TCM syndrome;Methods:choose 45 patients who has been diagnosed optic atrophy that caused by NAION,and discriminated deficiency of liver and kidney in traditional Chinese medicine.Then collect the patient's basic data,such as gender,the pathogenic eye and past medical history.For the detection of RAPD in quantitative we choose the neutral density filter method and collect the date about visual acuity,perimetry,OCT and visual evoked potential,then complete the TCM syndrome integral scale.Afterwards,probe the correlation between the values of RAPD with the inspection data and syndrome integral.On this basis,try to build a multiple regression equation to describe the relationship between them.Results:this group includes 24 men(53.3%)and 21 women(46.7%).23 cases(51.1%)show positive of the RAPD in the right eye,22 cases(48.9%)in the left eye.There is no difference in terms of gender and pathogenic eye;Minimum onset age is 34 years old,biggest onset age is 77 years old,average age is 54.09 ± 9.596 years old,the highest proportion of age is 50 to 55 years old.There are 16 cases(35.6%)have been Diagnosed cervical artery plaques and 17cases(37.8%)have had the hardening of the arteries or the early pathological changes such as endometrial thickening.Then 25 cases(55.6%)have been diagnosed obstructive sleep apnea syndrome(OSAS);And the patients that with high blood pressure,diabetes or hyperlipidemia are more than half.The value of RAPD has a linear correlation with the difference of visual acuity,MD,MS and RNFL.There has no obvious correlation between the value of RAPD with the VEP difference and TCM syndrome integral.Then a multiple regression equation is obtained:RAPD value = 0.09 +0.066 X MS difference + 0.003 x RNFL difference + 0.034 xvisual acuity difference.Conclusion:the onset of NAION is no bias in terms of gender and pathogenic eye.Its onset of age concentrates in the elderly;High blood pressure,diabetes,hyperlipidemia,OSAS and neck artery anomalies may are the risk factors for NAION.The value of RAPD has a close contact with perimetry,visual acuity and RNFL take second place;There is a Equation of the relationship between the four variables equation.And visual evoked potential has been found no significant correlation with the value of RAPD.And it lacks evidence about the relationship between the value of RAPD with TCM syndrome integral.