内窥镜鼻内视神经管减压治疗重症球后视神经炎

Observation on effect of optic nerve canal decompression on severe retrobulbar neuritis under nasal endoscope

目的观察内窥镜经鼻内视神经管减压治疗重症球后视神经炎的疗效。方法回顾分析1995年-2007年经眼科药物治疗16-20d其疗效欠佳转来我科的10例16眼资料(其中4例单眼,6例双眼),仅对视力极差的10例10眼施行减压治疗。结果对10眼视力无光感-30cm数指减压治疗,术后继续药物治疗16-20d,视力恢复到0.3-0.7。经1-8年观察视力0.5-1.0,眼底视乳头色泽正常,而未手术的6眼,视力无光感-20cm数指,眼底视乳头苍白萎缩,血管细小,呈鲜明对比,疗效迥然不同。结论经眼科药物治疗16-20d,视力仍无光感—眼前数指,CT,MRI检查,排除颅内病变而球后视神经明显增粗的重症病例,应行减压治疗,可恢复较好的视力。

Objective To observe the efficacy of optic nerve canal decompression on severe retrobulbar neuritis under nasal endoscope. Methods Retrospectively analyzed the ophthalmic data of 10 cases patients without good therapeutic effects who were treated with ophthahnic drugs for 16 to 20 days from 1995 to 2007. Among them, 4 cases were monocular and 6 cases were binocular. Only 10 eyes which had severe visual acuity received optic nerve canal decompression. Results The visual acuity of the ten eyes which were from no light perception to count-finger before operation were recovered to 0.3-0.7 after decompression treatment and medical treatment for 16-20 days. Followed up for 1-8 years, the visual acuity of the eyes kept stable at 0.5-1.0 with normal color of optic nerve head. And then the visual acuity of the six eyes which were not received decompression treatment still kept at light perception to 20cm count-finger with pallor color of optic nerve head. Conclusion Tile patients whose visual acuity remained no light perception or count-finger after medical therapy for 16-20 days in ophthalmology should receive optic nerve canal decompression if intracranial lesions has been excluded by CT and MRI, and their visual acuity still can recovere well.