中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
12期
1060-1064
,共5页
视神经炎%药物疗法%视敏度
視神經炎%藥物療法%視敏度
시신경염%약물요법%시민도
Optic neuritis%Drug therapy%Visual acuity
目的 观察特发性视神经炎(IDON)无光感眼的治疗情况及预后.方法 回顾性系列病例研究.临床病例来自中国中医科学院眼科医院2003年8月至2011年4月住院患者.观察17例(21只眼)IDON无光感患者经糖皮质激素冲击并配合其他药物治疗后出现光感时间、最佳矫正视力、视觉诱发电位(VEP)等情况,至少随访3个月.结果 21只眼无光感时间1.0 ～90.0 d,除1只眼90.0 d外,余20只眼平均无光感时间(12.5±10.6)d.治疗后14只眼(66.7％)部分恢复视力,出现光感的时间为治疗后2.0 ～25.0 d,平均(9.9±7.9)d.出院时最佳矫正视力为1只眼手动,2只眼指数,1只眼0.01,3只眼0.02,2只眼0.025,1只眼0.04,1只眼0.06,1只眼0.15,1只眼0.6,1只眼1.0.治疗前未见VEP波形者10只眼,治疗后5只眼出现P100波,但仍潜时延迟、振幅低；3只眼复查无波形；2只眼未行VEP复查.治疗前可见VEP波形者11只眼,治疗后8只眼VEP波形改善,2只眼VEP波形消失；1只眼未行VEP检查.随访时除1只眼视力提高外,其余眼视力稳定.结论 对就诊时无光感的视神经炎患者,不应放弃治疗；不能通过无光感时间的长短、出现光感时间的早晚和是否有VEP波形来评估视力预后.
目的 觀察特髮性視神經炎(IDON)無光感眼的治療情況及預後.方法 迴顧性繫列病例研究.臨床病例來自中國中醫科學院眼科醫院2003年8月至2011年4月住院患者.觀察17例(21隻眼)IDON無光感患者經糖皮質激素遲擊併配閤其他藥物治療後齣現光感時間、最佳矯正視力、視覺誘髮電位(VEP)等情況,至少隨訪3箇月.結果 21隻眼無光感時間1.0 ～90.0 d,除1隻眼90.0 d外,餘20隻眼平均無光感時間(12.5±10.6)d.治療後14隻眼(66.7％)部分恢複視力,齣現光感的時間為治療後2.0 ～25.0 d,平均(9.9±7.9)d.齣院時最佳矯正視力為1隻眼手動,2隻眼指數,1隻眼0.01,3隻眼0.02,2隻眼0.025,1隻眼0.04,1隻眼0.06,1隻眼0.15,1隻眼0.6,1隻眼1.0.治療前未見VEP波形者10隻眼,治療後5隻眼齣現P100波,但仍潛時延遲、振幅低；3隻眼複查無波形；2隻眼未行VEP複查.治療前可見VEP波形者11隻眼,治療後8隻眼VEP波形改善,2隻眼VEP波形消失；1隻眼未行VEP檢查.隨訪時除1隻眼視力提高外,其餘眼視力穩定.結論 對就診時無光感的視神經炎患者,不應放棄治療；不能通過無光感時間的長短、齣現光感時間的早晚和是否有VEP波形來評估視力預後.
목적 관찰특발성시신경염(IDON)무광감안적치료정황급예후.방법 회고성계렬병례연구.림상병례래자중국중의과학원안과의원2003년8월지2011년4월주원환자.관찰17례(21지안)IDON무광감환자경당피질격소충격병배합기타약물치료후출현광감시간、최가교정시력、시각유발전위(VEP)등정황,지소수방3개월.결과 21지안무광감시간1.0 ～90.0 d,제1지안90.0 d외,여20지안평균무광감시간(12.5±10.6)d.치료후14지안(66.7％)부분회복시력,출현광감적시간위치료후2.0 ～25.0 d,평균(9.9±7.9)d.출원시최가교정시력위1지안수동,2지안지수,1지안0.01,3지안0.02,2지안0.025,1지안0.04,1지안0.06,1지안0.15,1지안0.6,1지안1.0.치료전미견VEP파형자10지안,치료후5지안출현P100파,단잉잠시연지、진폭저；3지안복사무파형；2지안미행VEP복사.치료전가견VEP파형자11지안,치료후8지안VEP파형개선,2지안VEP파형소실；1지안미행VEP검사.수방시제1지안시력제고외,기여안시력은정.결론 대취진시무광감적시신경염환자,불응방기치료；불능통과무광감시간적장단、출현광감시간적조만화시부유VEP파형래평고시력예후.
Objective To evaluate the treatment outcomes of idiopathic optic neuritis with no light perception in 21 eyes.Methods This is a retrospective study.The hospital data of 17 patients (21 eyes)with idiopathic optic neuritis whose visual acuity were no light perception from August 2003 to April 2011 were retrospectively analyzed.These patients were treated with steroid pulse and other drugs.The clinical features,the time of appearance light perception,the best corrected visual acuity and VEP were measured.The follow-up was at least three months.Results Before the treatment,the average time of occurring no light perception were 1.0 ～ 90.0 days,except 1 eye was 90.0 days while the other 20 eyes was (12.5 ±10.6)days.After the treatment,vision improved in 14 eyes (66.7％) from Hand Move/30 cm to 20/20,the average time of appearance light perception was (9.9 ± 7.9) days.The best corrected vision acuity were 1 eye Hand Move,2 eyes Finger Count,1 eye 20/2000,3 eyes 20/1000,2 eyes 20/800,1 eye 20/500,1 eye 20/320,I eye 20/125,1 eye 20/32,1 eye 20/20.5 eyes with no VEP wave pattern emerge P100 after therapy,the other 2 eyes which had P100 was flatten after therapy.The follow-up found that except 1 eye vision improve outside,the rest eye vision remained stable.Conclusions The patients with optic neuritis who initially were no light perception should be treated promptly.The prognostic of vision can not be evaluated only by the duration time of no light perception,the appearing-time of light perception and the pattern of VEP.
