急性视神经炎临床特征和疗效分析
蓝育青，张驰，夏朝霞，彭蔚，肖剑晖
作者单位：（510120）中国广东省广州市，中山大学附属第二医院眼科
作者简介：蓝育青，女，医学博士，副教授，眼科主任，硕士生导师，从事青光眼视神经保护及青光眼滤过泡瘢痕防治的研究。
通讯作者：蓝育青[email protected]
收稿日期：2008-06-12修回日期：2008-08-03
Clinical features and treatment of acute optic neuritis
Yu-Qing Lan, Chi Zhang, Zhao-Xia Xia, Wei Peng, Jian-Hui Xiao
Department of Ophthalmology, the Second Affiliated Hospital of Sun Yat-sen University,Guangzhou 510120,Guangdong Province,China
Correspondence to: Yu-Qing Lan. Department of Ophthalmology, the Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong Province, [email protected]
Received:2008-06-12Accepted:2008-08-03
Abstract
AIM: To survey the clinical characteristics and the therapeutic effect of acute optic neuritis (AON).
METHODS: Fifty-four cases (81 eyes) of AON hos-pitalized from October 1996 to October 1997 were retrospectively analyzed in etiology, visual acuity, disturbance of pupil movement, changes of fundus, visual field and VEP, curative effect and prognosis.
RESULTS: The severe damage of visual function and various causes were found in AON of which multiple sclerosis (MS) accounted for 9%. Disturbance of pupil movement was 63% in which relative afferent papillary defect (RAPD) were the most common (78%). Abnormal changes were found in the ocular fundus for all the patients with papillitis optica. Visual field had different manifestation, and central scotoma was the most common (78%). Abnormal rate of VEP was high and unusual P latency was in 73%. Within intravenous methylpredni-solone (IVMP) and other synthetic treat-ment, the turative rate of AON reached to 62% and the effective rate was 83%. Curative effect wasnt related with the causes and types of the AON.Instead,the faster to get the treatment,the better the curative effect would be.
CONCLUSION: Visual function of AON is damaged heavily, but curative effect is satisfied. Prompt diagnose and treatment are keys to promote visual function and IVMP is reasonable and effective for AON.
KEYWORDS: acute optic neuritis; multiple sclerosis; etiology; methylprednisolone; curative effects
Lan YQ, Zhang C, Xia ZX, et al. Clinical features and treatment of 54 cases (81 eyes) of acute optic neuritis. Int J Ophthalmol (Guoji
Yanke Zazhi)2008;8(9):1935-1937
摘要
目的：观察和分析54例(81眼)急性视神经炎患者资料，探讨其临床特点和治疗效果。
方法：回顾性研究1996-10/2007-10入住我科的急性视神经炎患者54例（81眼）的发病原因、视力、瞳孔运动障碍、眼底、视野和视诱发电位（visual evoked potential,VEP） 的改变，治疗效果和预后。
结果：急性视神经炎发病原因较多，其中多发性硬化占9%，瞳孔运动障碍者占63%,以相对瞳孔传导阻滞（relative afferent papillary defect,RAPD）为主。急性视神经乳头炎（acute neuropapillitis）患者眼底均有不同程度的改变。视功能损害严重,视野表现多种改变，以中心暗点多见，占78%。VEP异常率高，以潜伏期延长为主，占73%。采用以静脉滴注甲基强的松龙(intravenous methylprednisolone，IVMP)为主的综合治疗后，患者视力显著提高，治愈率为62%，总有效率为93%。治疗效果与发病原因、视神经炎分型无关，与就诊时间有关，就诊时间越快，治疗效果越好。
结论：急性视神经炎发病原因多样，视功能损害重,但治疗效果较好，及时诊断和治疗是提高视功能的关键。
关键词：急性视神经炎；多发性硬化；病因；甲基强的松龙；疗效；
蓝育青，张驰，夏朝霞，等.急性视神经炎临床特征和疗效分析.国际眼科杂志2008;8(9):1935-1937
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