特发性视神经炎无光感21只眼临床观察  

The clinical outcomes of idiopathic optic neuritis with no light perception in 21 eyes

作　　者：李学晶[1] 童绎[1] 张守康[1] 

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中华眼科杂志》2012年第12期1060-1064,共5页Chinese Journal of Ophthalmology

摘　　要：目的观察特发性视神经炎（IDON）无光感眼的治疗情况及预后。方法回顾性系列病例研究。临床病例来自中国中医科学院眼科医院2003年8月至2011年4月住院患者。观察17例（21只眼）IDON无光感患者经糖皮质激素冲击并配合其他药物治疗后出现光感时间、最佳矫正视力、视觉诱发电位（VEP）等情况，至少随访3个月。结果21只眼无光感时间1．0—90．0d，除1只眼90．0d外，余20只眼平均无光感时间（12．5±10．6）d。治疗后14只眼（66．7％）部分恢复视力，出现光感的时间为治疗后2．0～25．0d，平均（9．9±7．9）d。出院时最佳矫正视力为1只眼手动，2只眼指数，1只眼0．01，3只眼0．02，2只眼0．025，1只眼0．04，1只眼0．06，1只眼0．15，1只眼0．6，1只眼1．0。治疗前未见VEP波形者10只眼，治疗后5只眼出现P100波，但仍潜时延迟、振幅低；3只眼复查无波形；2只眼未行VEP复查。治疗前可见VEP波形者11只眼，治疗后8只眼VEP波形改善，2只眼VEP波形消失；1只眼未行VEP检查。随访时除1只眼视力提高外，其余眼视力稳定。结论对就诊时无光感的视神经炎患者，不应放弃治疗；不能通过无光感时间的长短、出现光感时间的早晚和是否有VEP波形来评估视力预后。Objective To evaluate the treatment outcomes of idiopathic optic neuritis with no light perception in 21 eyes. Methods This is a retrospective study. The hospital data of 17 patients （21 eyes） with idiopathic optic neuritis whose visual acuity were no light perception from August 2003 to April 2011 were retrospectively analyzed. These patients were treated with steroid pulse and other drugs. The clinical features, the time of appearance light perception, the best corrected visual acuity and VEP were measured. The follow-up was at least three months. Results Before the treatment, the average time of occurring no light perception were 1.0 - 90. 0 days, except 1 eye was 90.0 days while the other 20 eyes was （ 12. 5 ± 10. 6）days. After the treatment, vision improved in 14 eyes （66.7%） from Hand Move/30 cm to 20/20, the average time of appearance light perception was （ 9. 9 ± 7. 9 ） days. The best corrected vision acuity were 1 eye Hand Move, 2 eyes Finger Count, 1 eye 20/2000, 3 eyes 20/1000, 2 eyes 20/800, 1 eye 20/500, 1 eye 20/320, 1 eye 20/125, 1 eye 20/32, 1 eye 20/20. 5 eyes with no VEP wave pattern emerge P100 after therapy, the other 2 eyes which had P100 was flatten after therapy. The follow-up found that except 1 eye vision improve outside, the rest eye vision remained stable. Conclusions The patients with optic neuritis who initially were no light perception should be treated promptly. The prognostic of vision can not be evaluated only by the duration time of no light perception, the appearing-time of light perception and the pattern of VEP.

关 键 词：视神经炎 药物疗法 视敏度 

分 类 号：R774.61[医药卫生—眼科]