非动脉炎性前部缺血性视神经病变的临床治疗现状

Current treatment advancement of nonarteritic anterior ischemic optic neuropathy

非动脉炎性前部缺血性视神经病变（NAION）是50岁以上人群常见的急性视神经病变，以突发、单眼、无痛性视力下降为特征。多种治疗方法被尝试用于治疗NAION，包括药物治疗和手术治疗，但是迄今为止尚无一种治疗方案被证实明确有效。近年的一项非随机前瞻性研究显示，患者急性期口服糖皮质激素可改善视力和视野，减轻视盘水肿，然而其确切疗效仍待证实。对于NAION患者进行的玻璃体腔内注射曲安奈德、抗血管内皮生长因子抗体、促红细胞生成素治疗的试验结果令人鼓舞，然而其所带来的风险不容忽视。目前，NAION的治疗尚缺乏有力的证据，有待更深入的研究，尤其要加强临床前的基础研究。

Non-arteritic anterior ischemic optic neuropathy （NAION） is the most common acute optic nerve disease of adults over age 50 years, characterized by unilateral, sudden, painless visual loss. Although there have been multiple therapies attempted, no effective treatment has been proven to reverse or limit the course of this disease either medicine or surgery. One recent large,nonrandomized controlled study suggested that oral steroids might be helpful for acute NAION. Others recently proposed interventions are intravitreal injection of steroids, anti-vascular endothelial growth factor （anti-VEGF） agents or erythropoietin, however, their potential side effects should be not ignored. Currently, no proven effective treatment is available. The intense research efforts on this enigmatic disorder are required, especially pre-elinical studies to produce new efficient approaches in therapy.