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Vojnosanitetski pregled
2018, vol. 75, br. 8, str. 773-779
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP150810356J

Creative Commons License 4.0
Klinička i ultrasonografska obeležja prednje ishemičke optičke neuropatije
aUniversity of Medicine and Pharmacy, Department of Neurology, Timisoara, Romania
bUniversity of Medicine and Pharmacy, Department of Ophthalmology, Timisoara, Romania
cUniversity of Medicine and Pharmacy, Department of Internal Medicine-Nephrology, 'Victor Babes', Timisoara, Romania

e-adresa: dcjianu@yahoo.com

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 AAION 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.

Ključne reči

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