目的评估活血通络颗粒对气虚血瘀型非动脉炎性前部缺血性视神经病变(NAION)的临床疗效。方法采用随机对照方法,将100例患者随机分为对照组和治疗组,治疗组51例(72眼),对照组49例(70眼)。对照组给予复方樟柳碱注射液颞浅动脉旁皮下注射,...目的评估活血通络颗粒对气虚血瘀型非动脉炎性前部缺血性视神经病变(NAION)的临床疗效。方法采用随机对照方法,将100例患者随机分为对照组和治疗组,治疗组51例(72眼),对照组49例(70眼)。对照组给予复方樟柳碱注射液颞浅动脉旁皮下注射,每次2 m L,每日1次。治疗组在上述治疗的基础上加用活血通络颗粒,每次10 g,口服,每日2次,2组均治疗3个月。观察2组视神经病变的总疗效,比较2组治疗前后视力、视野平均光敏感度的改善情况。结果干预后,治疗组视神经病变总有效率为88.24%,显著高于对照组71.43%,2组比较差异有统计学意义(P<0.05);治疗组视力和视野平均光敏感度显著增高,与对照组干预后比较差异有统计学意义(P<0.05)。结论活血通络颗粒联合复方樟柳碱注射液可显著改善NAION患者的视力和视野。展开更多
Background and Purpose -In acute ischemic stroke, the hypoperfused but viab le tissue is the main therapeutic target. In clinical routine, time-to-peak (TTP) maps are frequently used to estimate the hemodynamic compro...Background and Purpose -In acute ischemic stroke, the hypoperfused but viab le tissue is the main therapeutic target. In clinical routine, time-to-peak (TTP) maps are frequently used to estimate the hemodynamic compromise and to cal culate the mismatch volume. We evaluated the accuracy of TTP maps to identify pe numbral flow by comparison with positron emission tomography (PET). Methods -M agnetic resonance imaging (MRI) and PET were performed in 11 patients with acute ischemic stroke (median 8 hours after stroke onset, 60 minutes between MRI and PET imaging). The volumes defined by increasing TTP thresholds (relative TTP del ay of >2, >4, >6, >8, and >10 seconds) were compared with the volume of hypoperf usion ( < 20 mL/100 g per min) assessed by 15O-water PET. In a volumetric anal ysis, each threshold’ s sensitivity, specificity, and predictive values were ca lculated. Results -The median hypoperfusion volume was 34.5 cm3. Low TTP thres holds included large parts of the hypoperfused but also large parts of normoperf used tissue (median sensitivity/specificity: 93% /60% for TTP >2) and vice ve rsa (50% /91% for TTP >10). TTP >4 seconds best identifies hypoperfusion (84 % /77% ). The positive predictive values increased with the size of hypoperfus ion. Conclusion -This first comparison of quantitative PET-CBF with TTP maps in acute ischemic human stroke indicates that the TTP threshold is crucial to r eliably identify the tissue at risk; TTP >4 seconds best identifies penumbral fl ow; and TTP maps overestimate the extent of true hemodynamic compromise dependin g on the size of ischemia. Only if methodological restrictions are kept in mind, relative TTP maps are suitable to estimate the mismatch volume.展开更多
PURPOSE. To evaluate the relationship between reading performance and severity of disease in patients with retinitis pigmentosa (RP), assessed with routine cl inical psychophysical visual tests. METHODS. Seventy-six c...PURPOSE. To evaluate the relationship between reading performance and severity of disease in patients with retinitis pigmentosa (RP), assessed with routine cl inical psychophysical visual tests. METHODS. Seventy-six consecutive patients w ith RP (145 eyes), with reading acuity of at least 1.6 logMAR (logarithm of the minimum angle of resolution) in at least one eye, were examined. Each patient un derwent a complete ophthalmic evaluation, including visual acuity (Early Treatme nt Diabetic Retinopathy Study ETDRS charts), contrast sensitivity (Pelli-Robs on charts), visual field perimetry (Humphrey central 30-2 full-threshold progr am; Carl Zeiss Meditec, Dublin, CA), and a test of reading acuity, critical prin t size, and maximum reading speed (Minnesota Reading charts MNREAD). RESULTS. Reading acuity was 1.0 logMAR or more in the better eye of all but six (92%) pa tients. Maximum reading speed was better than 100 words per minute in the better eye of 59 (78%) subjects. Moderate to severe reading impairment, defined as re ading acuity of 0.4 logMAR or worse, was observed in the better eye of 47 (62%) patients. EDT RS visual acuity of 0.3 logMAR (20/40)-or worse was 89%sensitive and 66%speci fic when used as a criterion to define reading impairment. Contrast sensitivity and visual acuity correlated significantly with all three reading components, wh ereas mean light sensitivity in the central visual field (6°) demonstrated a hi gher correlation with maximum reading speed. The number of years elapsed since t he diagnosis of RP was a strong negative predictor of reading performance when c linical visual tests were taken into account, whereas a better reading ability c haracterized the patients with RP who had a higher level of education. A reduced reading speed with larger print size was found in 30 eyes (21%). This correlat ed with central light sensitivity, as it was more common among eyes with a mean sensitivity of< 10 dB. CONCLUSIONS. The reading performance of most patients wit h RP is only moderately impaired. It correlates with contrast sensitivity, visua l acuity, and visual field. It should be assessed in all cases, as disability ca n ensue, even when visual acuity is preserved. In patients with RP with poor rea ding performance, there is little potential for high-magnification devices beca use visual field constriction affects the reading rate.展开更多
文摘目的评估活血通络颗粒对气虚血瘀型非动脉炎性前部缺血性视神经病变(NAION)的临床疗效。方法采用随机对照方法,将100例患者随机分为对照组和治疗组,治疗组51例(72眼),对照组49例(70眼)。对照组给予复方樟柳碱注射液颞浅动脉旁皮下注射,每次2 m L,每日1次。治疗组在上述治疗的基础上加用活血通络颗粒,每次10 g,口服,每日2次,2组均治疗3个月。观察2组视神经病变的总疗效,比较2组治疗前后视力、视野平均光敏感度的改善情况。结果干预后,治疗组视神经病变总有效率为88.24%,显著高于对照组71.43%,2组比较差异有统计学意义(P<0.05);治疗组视力和视野平均光敏感度显著增高,与对照组干预后比较差异有统计学意义(P<0.05)。结论活血通络颗粒联合复方樟柳碱注射液可显著改善NAION患者的视力和视野。
文摘Background and Purpose -In acute ischemic stroke, the hypoperfused but viab le tissue is the main therapeutic target. In clinical routine, time-to-peak (TTP) maps are frequently used to estimate the hemodynamic compromise and to cal culate the mismatch volume. We evaluated the accuracy of TTP maps to identify pe numbral flow by comparison with positron emission tomography (PET). Methods -M agnetic resonance imaging (MRI) and PET were performed in 11 patients with acute ischemic stroke (median 8 hours after stroke onset, 60 minutes between MRI and PET imaging). The volumes defined by increasing TTP thresholds (relative TTP del ay of >2, >4, >6, >8, and >10 seconds) were compared with the volume of hypoperf usion ( < 20 mL/100 g per min) assessed by 15O-water PET. In a volumetric anal ysis, each threshold’ s sensitivity, specificity, and predictive values were ca lculated. Results -The median hypoperfusion volume was 34.5 cm3. Low TTP thres holds included large parts of the hypoperfused but also large parts of normoperf used tissue (median sensitivity/specificity: 93% /60% for TTP >2) and vice ve rsa (50% /91% for TTP >10). TTP >4 seconds best identifies hypoperfusion (84 % /77% ). The positive predictive values increased with the size of hypoperfus ion. Conclusion -This first comparison of quantitative PET-CBF with TTP maps in acute ischemic human stroke indicates that the TTP threshold is crucial to r eliably identify the tissue at risk; TTP >4 seconds best identifies penumbral fl ow; and TTP maps overestimate the extent of true hemodynamic compromise dependin g on the size of ischemia. Only if methodological restrictions are kept in mind, relative TTP maps are suitable to estimate the mismatch volume.
文摘PURPOSE. To evaluate the relationship between reading performance and severity of disease in patients with retinitis pigmentosa (RP), assessed with routine cl inical psychophysical visual tests. METHODS. Seventy-six consecutive patients w ith RP (145 eyes), with reading acuity of at least 1.6 logMAR (logarithm of the minimum angle of resolution) in at least one eye, were examined. Each patient un derwent a complete ophthalmic evaluation, including visual acuity (Early Treatme nt Diabetic Retinopathy Study ETDRS charts), contrast sensitivity (Pelli-Robs on charts), visual field perimetry (Humphrey central 30-2 full-threshold progr am; Carl Zeiss Meditec, Dublin, CA), and a test of reading acuity, critical prin t size, and maximum reading speed (Minnesota Reading charts MNREAD). RESULTS. Reading acuity was 1.0 logMAR or more in the better eye of all but six (92%) pa tients. Maximum reading speed was better than 100 words per minute in the better eye of 59 (78%) subjects. Moderate to severe reading impairment, defined as re ading acuity of 0.4 logMAR or worse, was observed in the better eye of 47 (62%) patients. EDT RS visual acuity of 0.3 logMAR (20/40)-or worse was 89%sensitive and 66%speci fic when used as a criterion to define reading impairment. Contrast sensitivity and visual acuity correlated significantly with all three reading components, wh ereas mean light sensitivity in the central visual field (6°) demonstrated a hi gher correlation with maximum reading speed. The number of years elapsed since t he diagnosis of RP was a strong negative predictor of reading performance when c linical visual tests were taken into account, whereas a better reading ability c haracterized the patients with RP who had a higher level of education. A reduced reading speed with larger print size was found in 30 eyes (21%). This correlat ed with central light sensitivity, as it was more common among eyes with a mean sensitivity of< 10 dB. CONCLUSIONS. The reading performance of most patients wit h RP is only moderately impaired. It correlates with contrast sensitivity, visua l acuity, and visual field. It should be assessed in all cases, as disability ca n ensue, even when visual acuity is preserved. In patients with RP with poor rea ding performance, there is little potential for high-magnification devices beca use visual field constriction affects the reading rate.
