NAION患者眼压干预治疗临床效果分析  

Clinical effect analysis of intraocular pressure intervention in patients with NAION

作　　者：王小堂 Xiao-Tang Wang(Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an 710004, Shaanxi Province, China)

机构地区：[1]中国陕西省西安市人民医院(西安市第四医院)眼科,710004

出　　处：《国际眼科杂志》2021年第8期1445-1448,共4页International Eye Science

摘　　要：目的:观察非动脉炎性前部缺血性视神经病变(NAION)患者眼压干预前后眼部血流动力学改善情况。方法:回顾性病例研究。收集2012-07/2018-09在西安市第四医院眼科就诊的NAION患者92例92眼,其中46例患者仅行基础治疗,未做降眼压处理,作为常规治疗组。另外46例患者在常规治疗的基础上采用布林佐胺滴眼液联合溴莫尼定滴眼液进行降眼压治疗,作为眼压干预组。比较两组治疗前后眼压、最佳矫正视力(BCVA)、视野平均缺损(MD)、视网膜神经纤维层厚度(RNFLT)、眼动脉和视网膜中央动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)和阻力指数(RI)情况。结果:两组患者治疗前眼压、BCVA(LogMAR)、MD、RNFLT、眼动脉和视网膜中央动脉PSV、EDV、PI和RI比较无差异(P>0.05)。治疗14d后,两组患者眼压、BCVA(LogMAR)、MD和RNFLT均较治疗前有显著改善(P<0.05),且眼压干预组改善效果更好(P<0.05);两组患者眼动脉和视网膜中央动脉PSV、EDV、PI均较治疗前增加,RI较治疗前降低;且眼压干预组眼动脉PSV、EDV、RI、PI和视网膜中央动脉PSV、EDV、RI与常规治疗组比较,变化更显著(P<0.05)。结论:眼压干预治疗可显著改善NAION患者眼部血流动力学指标,提高患者视力。AIM:To observe the improvement of ocular hemodynamics before and after intraocular pressure(IOP)intervention in patients with non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:Retrospective case series.Totally 92 patients(92 eyes)with NAION were admitted to the Department of Ophthalmology,Xi’an Fourth Hospital from July 2012 to September 2018.Forty-six patients received only basic treatment without IOP lowering treatment as the conventional treatment group.The other 46 patients were treated with brinzolamide eye drops combined with brimonidine eye drops to lower IOP on the basis of conventional treatment,as the IOP intervention group.Before and after treatment,the blood flow rate of the ophthalmic artery and central retinal artery were measured by color Doppler ultrasound.The IOP,best corrected visual acuity(BCVA),mean visual field defect(MD),retinal nerve fiber layer thickness(RNFLT),ophthalmic artery and central retinal artery peak systolic blood velocity(PSV),end-diastolic blood velocity(EDV),pulse index(PI)and resistance index(RI)were compared.RESULTS:Before treatment,there were no significant differences in IOP,BCVA(LogMAR),MD,RNFLT,PSV,EDV,PI and RI between the two groups(P>0.05).After 14d of treatment,IOP,BCVA(LogMAR),MD and RNFLT of the two groups were significantly improved compared with those before treatment(P<0.05),and the improvement effect of IOP intervention group was better,and the difference between the two groups was statistically significant(P<0.05).The PSV,EDV,PI of ophthalmic artery and central retinal artery in the two groups were increased compared with those before treatment,and RI was decreased compared with before treatment;and the changes of PSV,EDV,RI,PI of ophthalmic artery and PSV,EDV,RI of central retinal artery in the IOP intervention group were more significant than those in the conventional treatment group(P<0.05).CONCLUSION:IOP intervention can significantly improve the ocular hemodynamic indexes and improve the visual acuity of patients with NAION.

关 键 词：眼压 非动脉炎性前部缺血性视神经病变 眼部血流动力 

分 类 号：R774.6[医药卫生—眼科]