眼球破裂伤患者健侧眼视野缺损情况及应用糖皮质激素及神经营养药物的临床疗效  

Visual field defect and therapeutic effect of glucocorticoid and neurotrophy treatment on uninjured side Eye in eyeball rupture patients

作　　者：万超[1] 柳力敏[1] 赵宁[1] 刘宁宁[1] 才娜[1] 陈蕾[1] 

机构地区：[1]中国医科大学附属第一医院眼科,中国医科大学眼科中心,辽宁省糖尿病眼病防治中心,辽宁省沈阳市110001

出　　处：《眼科新进展》2015年第1期48-50,共3页Recent Advances in Ophthalmology

摘　　要：目的观察眼球破裂伤患者伤后健侧眼的视野变化及应用糖皮质激素及神经营养药物治疗的临床疗效。方法选取单眼眼球破裂伤患者227例227眼,观察伤后患者健侧眼的最佳矫正视力、视野检查的平均缺损和模式标准差等指标及其治疗前后的变化情况,并利用进展期青光眼干预研究视野缺损计分法对患者治疗前后的视野进行评分。结果平均随访时间18个月,患者单眼眼球破裂伤后,健侧眼视野出现环形周边视野缺损者179眼,半侧周边视野缺损者23眼,象限性视野缺损者6眼,广泛性阈值下降者4眼,视野未受损者15眼;患者的视野平均缺损值均低于同年龄段正常值,绝对值为(12.63±1.09)dB,模式标准差均高于同年龄段正常值,为(18.27±2.78)dB;视野缺损计分:无视野缺损者17眼,轻度缺损者74眼,中度缺损者136眼,无重度缺损及终末期缺损者;全身应用糖皮质激素及神经营养药物治疗后患者健侧眼最佳矫正视力下降者28眼,其中,视力提高者22眼,保持不变者6眼,其余患者未述健侧眼视力有改变;治疗后患者的视野平均缺损绝对值下降者199眼,保持不变者3眼,升高者25眼,绝对值为(4.37±2.13)dB;模式标准差下降者201眼,保持不变者2眼,升高者24眼,为(5.63±2.98)dB;视野缺损计分分值降低者212眼,升高者15眼。其中无视野缺损者128眼,轻度缺损者87眼,中度缺损者12眼,无重度缺损及终末期缺损者;治疗前后数值相比较,差异有统计学意义(P<0.01)。结论患者一侧眼眼球破裂伤后,健侧眼会出现视力下降及视野损伤,全身应用糖皮质激素及神经营养药物治疗能够改善健侧眼的视力和视野范围,对于眼球破裂伤患者,更要关注其健侧眼的情况。Objective To observe the variation of visual field and therapeutic effects of glucocorticoid and neurotrophy treatment on the uninjured side eye after eye- ball rupture. Methods A total of 227 cases （227 eyes） were treated, the variation of best corrected visual acuity, mean deviation and pattern standard deviation of the examination of visual field of the uninjured side eye were observed before and after treatment, and the field of vision was graded with the visual field deviation score （VFDS） method by Advanced Glaucoma Intervention Study （AGIS）. Result The mean follow- up time was 18 months, in the uninjured side eye after eyeball rupture, circularly peripheral visual field deviation appeared in 179 eyes,half peripheral visual field deviations in 23 eyes, quadrant of vision deviations in 5 eyes, extensive threshold visual field damage in 4 eyes, no visual field deviation in 15 eyes; The mean deviation values were lower than the normal value of the same ages,absolute value was （ 12.53 ± 1.09） dB,and PSD values were higher than the normal values of the same ages,which was （ 18.27 ±2.78 ） dB;VFDS：17 eyes were with no visual field deviation,74 eyes were slightly, 136 eyes were midrange, none grossly and of terminal stage;After treatment with glucocorticoid and neurotrophic pharmacotherapy, the 28 eyes with descendent best corrected visual acuity improved in 22 eyes, remained unchanged in 6 eyes;absolute value of mean deviation degraded in 199 eyes, remained unchanged in 3 eyes, and improved in 25 eyes, absolute value was （4.37 ±2. 13） dB;The value of PSD degraded in 201 eyes,remained unchanged in 2 eyes, and improved in 24 eyes, which was （5.63 ± 2.98 ） dB; The visual field deviation scores degraded in 212 eyes,improved in 15 eyes;VFDS：128 eyes were with no visual field deviation, 87 eyes were slightly, 12 eyes were midrange,none grossly and of terminal stage;There were statistical differences between those of before and after treatment （P 〈 0.01 ）. Conclusion The uninjure

关 键 词：眼球破裂伤 视野 平均缺损 模式标准差 视神经保护 

分 类 号：R681.53[医药卫生—骨科学]