目的：观察非动脉炎性前部缺血性视神经病变(NAION)患者视野表现类型及分布特征。

方法：回顾性观察性研究。分析2018-06/2023-12于中国中医科学院眼科医院神经眼科/针灸科确诊为NAION的患者183例246眼。记录临床相关信息，包括人口学特征、发病情况、病程、全身危险因素、烟酒史、最佳矫正视力(BCVA)、视野指数(VFI)、视野缺损类型、视盘神经纤维层厚度(pRNFL)。

结果：纳入患者183例246眼，其中男101例，女82例； 单眼患病120例，双眼63例； 就诊年龄29-81(平均56.20±9.78)岁。视野为弥漫缺损90眼(36.6%)、下半部缺损63眼(25.6%)、环形暗点32眼(13.0%)、弓形暗点22眼(8.9%)、象限性缺损11眼(4.5%)、扇形或楔形缺损15眼(6.1%)、上半部缺损13眼(5.3%)。视野弥漫缺损型患者的BCVA(LogMAR)和VFI较其他类型患者差(均P<0.05)。不同性别及年龄段的患者不同视野缺损间比较有差异(均P<0.05)，而高血压病、糖尿病、高脂血症、睡眠呼吸暂停综合症、烟酒史、疾病分期在不同视野缺损间比较均无差异(均P>0.05)。

结论：NAION视野损害具有多样性的特征，不同性别、年龄段、不同视功能受损程度的患者有着相对特征性的视野缺损表现类型，但NIAON视野差异性表现的原因仍需进一步大样本探究。

METHODS: Retrospective observational study. The investigation encompassed 183 patients(246 eyes)diagnosed with NAION who were evaluated at the Neuro-Ophthalmology/Acupuncture Department within the Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023. Recorded clinical data covered demographic details, incidence, disease duration, presence of systemic diseases, and histories of tobacco and alcohol use, along with best-corrected visual acuity(BCVA), visual field index(VFI), type of visual field defect, and thickness of the peripapillary retinal nerve fiber layer(pRNFL).

RESULTS: A total of 183 patients(246 eyes)were enrolled. The cohort consisted of 101 males and 82 females; 120 exhibited unilateral symptoms, while 63 showed bilateral symptoms, with a mean age of 56.20±9.78 years(range 29-81 years). The types of visual field defects observed were varied: 90 eyes(36.6%)had diffuse loss, 63 eyes(25.6%)experienced inferior hemifield loss, 32 eyes(13.0%)displayed ring scotomas, 22 eyes(8.9%)had arcuate scotomas, 11 eyes(4.5%)presented with quadrant defects, 15 eyes(6.1%)had sectorial or wedge defects, and 13 eyes(5.3%)showed superior hemifield loss. The BCVA(LogMAR)and VFI of patients with diffuse visual field loss were poorer than patients with other types of visual defects(all P<0.05). There were statistically significant differences in visual field defects among patients of different genders and ages(all P<0.05). However, history of hypertension, diabetes, hyperlipidemia, sleep apnea and other systemic diseases, history of smoking and alcohol, and course of disease did not show specificity in the NAION visual field(all P>0.05).

CONCLUSION:NAION manifests with a broad spectrum of visual field impairments across different genders, age, and levels of visual functionality. Extensive future research is necessary to identify additional reasons influencing the types of visual field damage in NAION.