复方樟柳碱治疗糖尿病缺血性视神经病变疗效观察

目的:观察复方樟柳碱治疗糖尿病缺血性视神经病变的效果。方法:41例(63眼)随机分成两组。治疗组21例(33眼)采用患眼颞浅动脉旁皮下注射、球周注射复方樟柳碱;对照组20例(30眼)采用静脉输入血管扩张剂,注射维生素B1、B12等。观察60d。结果:两组比较结果,视力、视野、电生理差异显著,复方樟柳碱疗效明显优于对照组。结论:复方樟柳碱治疗糖尿病缺血性视神经病变是一种安全、可靠的治疗手段。     

复方樟柳碱联合后Tenon囊下注射曲安奈德治疗前部缺血性视神经病变

目的:观察复方樟柳碱联合后Tenon囊下注射曲安奈德治疗前部缺血性视神经病变的疗效。方法:临床确诊的前部缺血性视神经病变患者58例60眼随机分为两组,其中29例30眼接受复方樟柳碱侧颞浅动脉旁注射联合曲安奈德20mg后Tenon囊下注射(治疗组);另外29例30眼采用复方樟柳碱侧颞浅动脉旁注射治疗(对照组);均以15d为1个疗程。两组患者用药后每天观察视力变化及视乳头水肿消退情况,治疗前有视野者复查视野。结果:治疗15d后,两组视力,视野及视乳头水肿情况均有不同程度改善,治疗组视力提高程度明显高于对照组,两组间差异有统计学意义(χ2=17.8,P<0.01);治疗组有视野检查的14眼中治疗后好转12眼(86%),2眼无变化(14%);对照组有视野检查的13眼中治疗后视野好转4眼(31%),9眼无变化(69%),两组视野变化比较差异有统计学意义(χ2=8.68,P<0.05)。结论:复方樟柳碱联合曲安奈德治疗AION优于单纯复方樟柳碱治疗。     

复方樟柳碱注射液治疗缺血性视神经病变的疗效观察

目的：观察复方樟柳碱注射液对缺血性视神经病变的疗效.方法：采用随机对照方法,将31例（46眼）缺血性视乳头病变患者随机分为治疗组17例（28眼）、对照组14例（18眼）,对照组采用妥拉苏林注射液25mg,治疗组采用复方樟柳碱注射液2mL,患侧颞浅动脉旁皮下注射1次/d,每次2mL（急重症者可加球旁注射,1次/d）,14次为1疗程.以视力、视野改变为疗效判断指标.结果：经1疗程治疗后,治疗组视力治愈率为32%,显效率为43%;治疗组视野缺损治愈率为39%,显效率为36%,治疗组与对照组比较,差异有显著性意义.结论：复方樟柳碱注射液和妥拉苏林注射液对缺血性视神经病变均有治疗作用,但复方樟柳碱注射液优于妥拉苏林注射液.     

复方樟柳碱联合针灸治疗缺血性视神经病变的疗效观察

目的:观察复方樟柳碱注射液联合针灸治疗缺血性视神经病变的疗效。方法:采用随机对照研究方法,将缺血性视神经病变患者34例(38眼)随机分为治疗组22例(24眼)、对照组12例(14眼)。治疗组采用复方樟柳碱注射液患侧颞浅动脉旁皮下注射联合针灸疗法;对照组采用地塞米松、复方丹参注射液静脉滴注。1次/d,疗程21d。以视力和视野作为观察和评估的指标,比较两组的疗效。结果:治疗组的有效率为79%,对照组的有效率为64%。结果显示治疗组的疗效优于对照组(P<0.01)。结论:复方樟柳碱注射液联合针灸治疗缺血性视神经病变有较好的疗效。     

复方樟柳碱治疗视网膜中央动脉阻塞40例

目的比较复方樟柳碱球后注射联合颞浅动脉旁注射与单纯颞浅动脉旁注射治疗视网膜中央动脉阻塞对其视力、视野等影响的差别,评价其对视网膜中央动脉阻塞的疗效。方法观察2005年10月至2007年10月20例20眼采用复方樟柳碱球后注射联合颞浅动脉旁注射的治疗组与20例20眼单纯颞浅动脉旁注射治疗的对照组视网膜中央动脉阻塞患者的视力、视野变化,并进行对照分析。结果复方樟柳碱球后注射联合颞浅动脉旁注射与单纯颞浅动脉旁注射有效率进行比较分析,用药后7 d和用药后14 d治疗组与对照组比较,差异有统计学意义,在提高视力,改善视野上,2组差异有统计学意义。结论应用复方樟柳碱球后注射联合颞浅动脉旁注射治疗视网膜中央动脉阻塞是一种有效的治疗方法。     

低分子肝素钠治疗前部缺血性视神经病变疗效观察

目的 观察低分子肝素钠治疗前部缺血性视神经病变的疗效.方法 临床病例系列研究.对2010年5月至2013年10月在河北大学附属医院眼科经临床确诊的前部缺血性视神经病变患者80例86只眼,分为治疗组(40例44只眼)和对照组(40例42只眼),2组均接受常规治疗,包括静脉滴注长春西汀、辅酶A、ATP,球后注射地塞米松、盐酸消旋山莨菪碱注射液、利多卡因注射液,配合维生素B1、甲钴胺片口服,14 d为1个疗程.治疗组在常规治疗的基础上加用低分子肝素钠5 000单位腹壁脐周皮下注射,1次/d,连用14 d.两组患者用药后每天观察视力、眼底变化,治疗前有视野检查者复查视野.结果 治疗组治疗后的视力、视野均较治疗前明显提高,差异有统计学意义(分别为t =3.363,2.858,P=0.002和0.007,P＜0.05);治疗组视力提高的总有效率及显效率均高于对照组,两组间差异有统计学意义(x2=7.63,P=0.006,x2=4.63,P=0.034,P＜0.05).治疗组视野改善的总有效率及显效率均高于对照组,两组间差异有统计学意义(x2=9.77,x2=5.05,P=0.0314 P=0.025,P＜0.05).结论 低分子肝素钠治疗前部缺血性视神经病变能明显提高疗效,改善视功能.     

阿魏酸钠治疗缺血性视神经病变疗效观察

目的 探讨阿魏酸钠注射液治疗缺血性视神经病变的临床效果。方法 120例(120只眼)缺血性视神经病变患者，随机分成治疗组和对照组各60例。对照组给予常规治疗，治疗组给予阿魏酸钠注射液300mg／d静脉滴注，15天为一疗程。测定治疗前后视力、视野、视网膜中央静脉血流速度(CRV)、视网膜中央动脉平均收缩期峰值血流速度(PSV)。结果 应用阿魏酸钠治疗后，视力、视野明显改善，CRV和PSV显著提高，与对照组治疗后相比均有显著性差异，疗效优于对照组。结论 阿魏酸钠治疗缺血性视神经病变疗效显著。     

爱维治治疗前部缺血性视神经病变的疗效观察

目的 观察爱维治治疗前部缺血性视神经病变（AION）的疗效。 方法 临床确诊的AION患者58例60只眼，其中29例30只眼接受爱维治1200 mg/d静脉滴注治疗（治疗组）；另外29例30只眼接受1～2种溶栓抗凝剂或血管扩张剂1次/d静脉滴注治疗（对照组）。均以15 d为1个疗程。对照组中20只眼还同时进行眼局部药物注射，包括糖皮质激素、654-2球后或球旁注射，1次/d或1次/2 d，用药3～5次。两组患者用药后每天观察视力、眼底变化，治疗前有视野检查者复查视野。 结果 治疗组视力提高程度明显好于对照组，两组间差异有统计学意义(t=2.74, P<0.01); 用药第3天，两组视力提高程度差异无统计学意义(t=1.34, P＞0.05); 第5、10、15天，治疗组视力提高程度明显好于对照组，其差异有统计学意义（t=2.01, P<0.05; t=2.07, P<0.05; t=2.74, P<0.01）；治疗组有视野检查的15只眼中，13只眼治疗后视野好转，占87.00%；2只眼无变化，占13.00%。对照组有视野检查的13只眼中，4只眼治疗后视野好转，占31.00%；9只眼无变化，占69.00%。两组视野变化的差异比较有统计学意义（χ2=9.66,P<0.01）。 结论 爱维治治疗AION有效。 (中华眼底病杂志, 2006, 22: 97-99)     

球后注射山莨菪碱联合高压氧治疗非动脉炎性前部缺血性视神经病变的疗效观察

目的 观察球后注射山莨菪碱联合高压氧治疗非动脉炎性前部缺血性视神经病变的疗效.方法 选取2015年6月-2016年6月我院收治的60例非动脉炎性前部缺血性视神经病变患者,随机分为2组:治疗组和对照组,2组均给予皮质激素、血管扩张剂、营养神经类药物等治疗.治疗组在此基础上给予山莨菪碱球后注射联合高压氧,15天后除了停止球后注射山莨菪碱,其余治疗不变,30天后比较2组治疗前后视力、视野的改变.结果 视力治疗组治愈13眼,显效4眼,有效10眼,无效3眼.对照组治愈6眼,显效12眼,有效8眼,无效4眼.两组对比经ndit分析Z=-3.074,P=0.002.视野治疗组治愈15眼,显效9眼,有效3眼,无效3眼.对照组治愈3眼,显效8眼,有效14眼,无效5眼,两组经ridit分析Z=-3.504,P=0.000.结论 球后注射山莨菪碱联合高压氧治疗缺血性视神经病变疗效较好.     

综合疗法治疗非动脉炎性前部缺血性视神经病变

目的观察复方樟柳碱联合高压氧综合治疗非动脉炎性前部缺血性视神经病变(NAION)的疗效。方法采用随机方法将患者58例(64只眼)分入观察组30例和对照组28例。对照组采用局部注射激素,全身应用低分子右旋糖酐、复方丹参液、神经营养剂。观察组:除应用同对照组相同的药物外,予复方樟柳碱作患侧颞浅动脉旁皮下注射,配合高压氧综合治疗。以视力、视野、眼底改变为疗效判断指标。结果有效率治疗组为83.33%,对照组为53.57%,二者比较,差异有显著性意义(P<0.05)。结论复方樟柳碱联合高压氧综合疗法可提高非动脉炎性前部缺血性视神经病变的疗效。     

Suspected Simultaneous Bilateral Anterior Ischemic Optic Neuropathy in a Patient with Behçet's Disease

Aim: To report a 47-year-old Japanese woman with a one-year history of Behçet's disease who complained of sudden bilateral visual loss with concurrent anterior ischemic optic neuropathy (AION). Case Report: The patient's Snellen visual acuity was 0.1 (OD) and 0.3 (OS) of onset. There was bilateral mild anterior chamber inflammation. Bilateral optic disc pale swelling was observed without retinal exudates and edema. Fluorescein angiography demonstrated bilateral hypofluorescence of the optic disc in early frames but with no distinct retinal vasculitis. Visual field showed bilateral relative central scotoma and right altitudinal hemianopsia. Laboratory examination revealed an ESR of 26 mm in the first hour with a C-reactive protein level of < 0.3 mg/dl. Periocular injection of triamcinolone acetonide in both eyes without systemic corticosteroid administration improved her visual acuity to 0.7 (OD) and 1.2 (OS) within 45 days of onset. Bilateral optic disc swelling gradually resolved. In the early stages, fluorescein angiography demonstrated normal optic disc filling in both eyes. There was a residual right central scotoma on visual field. Conclusion: We observed an extremely rare case of simultaneous bilateral AION with Behçet's disease with marked visual recovery within 45days of onset.     

Suspected simultaneous bilateral anterior ischemic optic neuropathy in a patient with Behçet's disease

AIM: To report a 47-year-old Japanese woman with a one-year history of Beh?et's disease who complained of sudden bilateral visual loss with concurrent anterior ischemic optic neuropathy (AION). CASE REPORT: The patient's Snellen visual acuity was 0.1 (OD) and 0.3 (OS) of onset. There was bilateral mild anterior chamber inflammation. Bilateral optic disc pale swelling was observed without retinal exudates and edema. Fluorescein angiography demonstrated bilateral hypofluorescence of the optic disc in early frames but with no distinct retinal vasculitis. Visual field showed bilateral relative central scotoma and right altitudinal hemianopsia. Laboratory examination revealed an ESR of 26 mm in the first hour with a C-reactive protein level of < 0.3 mg/dl. Periocular injection of triamcinolone acetonide in both eyes without systemic corticosteroid administration improved her visual acuity to 0.7 (OD) and 1.2 (OS) within 45 days of onset. Bilateral optic disc swelling gradually resolved. In the early stages, fluorescein angiography demonstrated normal optic disc filling in both eyes. There was a residual right central scotoma on visual field. CONCLUSION: We observed an extremely rare case of simultaneous bilateral AION with Beh?et's disease with marked visual recovery within 45 days of onset.     

Visual Loss Due to Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) Immediately Following Routine Strabismus Surgery Under General Anesthesia—A Case Report

Purpose: To report a case of non-arteritic anterior ischemic optic neuropathy (NAION) observed immediately after uncomplicated strabismus surgery performed under general anesthesia.

Methods: A 61-year-old woman underwent an uncomplicated strabismus surgery of her right eye under general anesthesia. Preoperatively visual acuity (VA) was LogMAR 0.18 in both eyes. Design: Retrospective, observational case report and literature review.

Results: Two days following surgery, patient presented with painless visual loss. VA was No Perception of Light (NPL). Fundoscopy revealed right optic disc swelling and relative afferent pupillary defect. Perioperatively patient experienced 2 hypotensive episodes. She was evaluated for alternative etiologies of her optic neuropathy, with negative results. She was found to have mild hypercholesterolemia, which was not known prior to surgery. After 2 months she developed optic atrophy in the affected eye and the visual acuity did not recover.

Conclusions: To our knowledge, this is the first documented case of non-arteritic anterior ischemic optic neuropathy occurring immediately after strabismus surgery.     

Bilateral posterior ischemic optic neuropathy following subdural hematoma drainage

PURPOSE: We report a case of bilateral posterior ischemic optic neuropathy after subdural hematoma drainage. CASE: A 52-yr-old man under continuous peritoneal dialysis underwent subdural hematoma drainage. After administration of a sedative, he complained of bilateral visual loss. His visual acuity was light perception in the right eye and no light perception in the left eye. Neither pupil reacted to light stimulus. Funduscopic findings revealed a slightly pale optic disc and renal retinopathy with macular folds in both eyes. No other neuro-ophthalmologic or neurologic abnormalities were observed. Based on these findings, the patient was diagnosed as having bilateral posterior ischemic optic neuropathy and was treated with intravenous corticosteroids. From about 50 days after the operation, visual acuity gradually improved, and papillary light reaction was immediate. In cranial magnetic resonance imaging, no characteristic lesions of multiple sclerosis could be detected. Six months later, visual acuity improved to 20/20 in both eyes. CONCLUSION: In patients with renal failure and underlying systemic vascular disease and anemia, the risk of posterior ischemic optic neuropathy should be considered even in minor surgery with stable vital signs and without severe blood loss.     

法舒地尔治疗非动脉炎性缺血性视神经病变

目的：观察法舒地尔治疗非动脉炎性缺血性视神经病变的临床效果。

方法：自2012-03/2013-06收治的缺血性视神经病变患者70例随机分为观察组(法舒地尔治疗组)和对照组(常规治疗组)各35例,治疗周期均为4wk,观察比较两组的最佳矫正视力和视野。

结果：观察组最佳矫正视力总有效率为86%; 对照组总有效率为57%,两组比较差异显著,具有统计学意义(P<0.05)。观察组视野好转率为83%,对照组视野好转率为57%,两组比较差异显著,具有统计学意义(P<0.05)。

结论：法舒地尔治疗非动脉炎性缺血性视神经病变效果优于传统药物。     

Intravitreal injection of triamcinolone acetonide in nonarteritic anterior ischemic optic neuropathy

BackgroundSystemic corticosteroid may play a vital role in treating nonarteritic ischemic optic neuropathy (NAION). An intravitreal route provides the advantage of avoiding systemic side effects. In this study, we investigated the treatment result of intravitreal injection of acetonide (IVITA).MethodsWe retrospectively reviewed six patients with NAION who were treated with a single IVITA. The patients were followed monthly for 6 months.ResultsVisual acuity improved in three patients. One patient also had a better visual field at the 6^th month follow up. Two patients with more severe swelling of the optic disc initially did not gain better visual acuity. One patient with a pre-existing epiretinal membrane maintained stable visual acuity.ConclusionSome patients with NAION may improve with IVITA treatment. Further randomized controlled clinical trials are needed.     

前部缺血性视神经病变的回顾分析

目的:掌握前部缺血性视神经病变的临床检查、诊断、治疗方法,挽救视功能。方法:回顾性分析32例缺血性视神经病变患者的临床检查治疗过程,观察治疗前后的视力变化、视野变化、OCT、眼底荧光血管造影结果等。结果:32例前部缺血性视神经病变病例中,通过控制全身疾病,局部激素治疗,扩张血管药物促循环,营养神经治疗,大部分病例视力有所提高,视盘水肿减轻,视野不同程度扩大,患眼OCT示:盘周神经纤维层变薄。结论:前部缺血性视神经病变的正确诊断,及时系统的治疗,可有效提高视力,改善视盘缺血状态,扩大视野、提高视敏度。     

Nonarteritic posterior ischemic optic neuropathy treated with optic nerve sheath decompression Report of two cases

Posterior ischemic optic neuropathy (PION) is a rare form of ischemic optic neuropathy that is thought to be due to impaired blood flow in the posterior circulation of the optic nerve. It presents with acute monocular loss of vision and impaired visual field in the presence of a normal appearing optic disc. Infectious, demyelination, and compressive optic neuropathy must be excluded in order to make the diagnosis of nonarteritic PION (NPION). To our knowledge, this is the first report of NPION successfully treated with optic nerve sheath fenestration. We treated two patients within four and six days of the onset of symptoms. Visual acuity and visual fields improved rapidly and permanently in both patients.     

葡萄膜炎并发白内障术后前房注射地塞米松的疗效观察

目的:探索白内障摘除术后前房注射0.1mL地塞米松对葡萄膜炎并发白内障患者术后的影响。方法:试验组术后前房注射0.1mL地塞米松,对照组前房未注射地塞米松,观察两组术后炎症反应。结果:术后前2d两组患者视力间差别有统计学意义(P<0.05),术后第1d角膜水肿程度两组间有统计学差异(P<0.05),前房闪辉差异有统计学意义(P<0.05),且试验组术后患者视力提高者百分比高于对照组。结论:葡萄膜炎并发白内障患者行白内障超声乳化+人工晶状体植入术,术毕前房注射0.1mL地塞米松者可减轻短期术后炎症反应,可更早提高患者视力,对患者术后短期眼压未见明显影响。     

Subretinal neovascularization in anterior ischemic optic neuropathy

A 66-year-old man with typical anterior ischemic optic neuropathy in one eye suffered from edema of the optic disc without functional changes in the fellow eye. However, 7 months later, a reduction in visual acuity, a change in the visual field and a worsening of the contrast-sensitivity curve demonstrated the development of typical anterior ischemic optic neuropathy in this eye as well. After another 6-month period, in addition to these changes, an extensive subretinal neovascular membrane developed in the papillomacular area, which further reduced the patient's visual acuity and required treatment with laser photocoagulation. To our knowledge, this is the first case report of the occurrence of a subretinal neovascular membrane as a complication of anterior ischemic optic neuropathy. Offprint requests to: G. Giuffre