31例非动脉炎性缺血性视神经病变的综合治疗效果探讨

Effect of Combined Therapy for Nonarteritic Anterior Ischemic Optic Neuropathy

目的探讨非动脉炎性缺血性视神经病变的临床综合治疗效果,为预防此病进程提供依据。方法回顾性分析了31例非动脉炎性缺血性视神经病变的临床症状、眼底改变、视野图像、眼底荧光造影及彩色多普勒眼底血流检查结果,并使用血栓通及复方樟柳碱等药物综合治疗。结果31例38眼中,经综合治疗后,其中18眼视力有提高,视野暗区变淡或缩小,有效率47.4%。16眼(42.1%)视力无明显改善,4眼(10.5%)视力下降。结论非动脉炎性缺血性视神经病变使用血栓通及复方樟柳碱等药物治疗可有效改善视网膜循环,提高视力。高血压患者合并有NAION的患者使用过强的降血压药物和血压偏低的NAION患者使用大量扩血管药物治疗时,要监测血压的变化。治疗非动脉炎性缺血性视神经病变的同时应行全身有关危险因素检查和治疗。

Objective To study the effect of combined therapy of nonarteritic anterior ischemic optic neuropathy and to provide evidence for the prevention of this disease entity. Methods Clinical data from 31 patients with nonarteritic anterior ischemic optic neuropathy （NAION） were retrospectively analyzed, and then treated with thrombolysin pills and composite anisodine. Results After the combined therapy, 18/38 eye-sights improved, the dark area in visual field became thin or contracted, the effective rate was 47.4% ; and 16 eyes （42.1% ） had no obvious improvement, 4 eyes （ 10..5% ） worsened. Conclusion Medical therapy improves the retina circulation effectively, thus increases visual acuity. Patients with hypertension associated with NAION usually receive antihypertensive medications, however, if the patients＇ receive active antihypertensive remedy their BP should be monitored. In treatment of patients with NATION, the relevant systemic risk factors should be concerned.