目的 探讨激素联合个性化药物治疗非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy, NAION)的效果。方法 选取NAION患者56例(61眼),根据其病因、发病时间、眼部检查、视野检查及眼底荧光血管造影(FFA)结果,制定激素联合个性化药物治疗方案,观察治疗前后视力、视野、眼底改善情况,判断综合疗效。结果 治疗后56例(61眼)视力均明显改善;治疗前56例(61眼)视野均出现特征性改变,治疗后视野缺损范围较治疗前缩小30°以上者48眼,显效率78.7%;治疗前FFA检查56例(61眼)荧光造影特征性改变, 治疗后54眼荧光造影改善,显效率88.5%。结论 激素联合个性化药物治疗,对NAION病预后有明显改善作用。
Abstract
Objective To study the therapeutic effect of hormone combined with an individualized drug therapy against non-arteritic anterior ischemic optic neuropathy (NAION). Methods A total of 56 cases(61 eyes) diagnosed with NAION between January 2012 and December 2015 were selected. According to etiology,oneset time of disease and results of ocular examination,visual field examination and fundus fluorescence angiography(FFA), treatment regimens were chosen that involved hormone combined with individualized medication. Improvements of visual acuity、visual fields and FFA after treatment were observed. The overall curative effect was evaluated. Results Vision was improved in each of the 56 cases (61 eyes)after treatment.Before treatment, characteristic changes of the visual field were detected in all the 61 eyes. After treatment, the range of the visual field defect was reduced by at least 30° in 48 eyes, and the effective rate was 78.7%. FFA confirmed 56 cases of characteristic changes in fluorescein angiography before treatment. After treatment, the fluorescein angiography was significantly improved in 54 eyes, and the effective rate was 88.5%. Conclusions The treatment of NAION with hormone combined with individualized medication can considerably improve the prognosis of patients.
关键词
NAION /
激素 /
个性化治疗
Key words
NAION /
hormone /
individualized drug therapy
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参考文献
[1] 陆 方,严 密.非动脉炎性前部视神经缺血性视神经疾病危险因素的研究[J].中华眼底病杂志,2008,24(13):86-89.
[2] 葛 坚.眼科学[M].北京:人民卫生出版社,2006:330-331.
[3] 张承芬.眼底病学[M].北京:人民卫生出版社,1998:484-490.
[4] Hayreh S S,Zimmerman M B.Nonarteritic anterior ischemic optic neuropathy:Role of systemic corticosteroid therapy[J].Graefes Arch Clin Exp Opthalmol,2008,246(7):1029-1046.
[5] 王润生,吕沛霖,王小娣,等.正常人视盘、视杯形态及盘周神经纤维层光学相干断层定量检测[J].国际眼科杂志,2007,9(6):383-384.
[6] Miller N R,Arnold A C.Current concepts in the diagnosis,pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy[J].Eye (Lond),2015,29(1):65-79.
[7] 钟 勇,陈 婷.评价非动脉炎性前部缺血性视神经病变的治疗策略[J].中华眼科杂志,2019,55(3):164-168.
[8] Kinori M,Ben-BassatⅠ,Wasserzurg Y,et al.Visuai outcome of mega-dose intravenous corticosteroid treatment in nonarteritic anterior ischemic optic neuropathy:retrospective analysis[J].BMC Ophthalmol,2014,14(1):62-66.
[9] 王建民,赵 云.非动脉炎性前部缺血性视神经病变的糖皮质激素治疗[J].中国实用眼科杂志, 2011,29(11):1119-1123.
[10] Ronald M,Burde M D.Optic disk risk factor for nonarteritic anterior ischemic optic neuropathy[J]. J Ophthamol,1993,116(6):759-764.
[11] 钟 勇,陈 婷.努力提高非动脉炎性前部缺血性视神经病变临床诊疗水平[J].中华眼底病杂志,2015,31(6):521-523.
[12] 张红霞.80例非动脉炎性缺血性视神经病变疗效分析[J].河南职工医学院学报,2013,2(2):153-154.
[13] 中华医学会眼科学分会神经眼科学组.我国非动脉炎性前部缺血性视神经病变诊断和治疗专家共识(2015年)[J].中华眼科杂志,2015,51(5):323-326.
[14] 潘维花,张晓君,李毅斌,等. 非动脉炎性前部缺血性视神经病危险因素研究[J].中华眼底病杂志,2008,2(7):86-89.
[15] 张 明,徐丽君,邓丽影.依达拉奉注射液治疗急性脑梗死疗效及安全性随机双盲多中心研究[J].中国新药与临床杂志,2007,26(2):105-108.
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