外伤性视神经病变的诊断和治疗进展  

Progress in diagnosis and treatment of traumatic optic neuropathy

作　　者：刘锐[1] 王沁 胡晓蕾 田国红 徐全刚[4] LIU Rui;WANG Qin;HU Xiaolei;TIAN Guohong;XU Quangang(Department of Opthalmology,Chongqing Aier Ophthalmology Hospital,Chongqing 400020,China;Chongqing Shapingba Hospital,School of Medicine,Chongqing University,Chongqing 400000,China;Department of Ophthalmology,Eye&ENT Hospital,Fudan University,NHC Key Laboratory of Myopia and Related Eye Diseases,Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai 200031,China;Department of Neuro-ophthalmology,the Third Medical Center,PlA General Hospital,Beijing 100039,China)

机构地区：[1]重庆爱尔眼科医院眼科,重庆400020 [2]重庆大学附属沙坪坝医院眼科,重庆400000 [3]复旦大学附属眼耳鼻喉科医院眼科、国家卫生健康委员会近视眼及相关眼病重点实验室、上海市视觉损害与重建重点实验室,上海200031 [4]解放军总医院第三医学中心神经眼科,北京100039

出　　处：《中国眼耳鼻喉科杂志》2024年第6期516-520,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：外伤性视神经病变(TON)是导致严重视功能障碍的急性视神经损伤,为颅面外伤的一种常见并发症,病因分为直接损伤或间接损伤,后者更常见。近年来,TON的发病率呈逐渐上升趋势,一旦发生可能会严重影响患者生活质量,故需早期诊断并及时治疗。TON的诊断除了眼科常规检查外,还需结合神经眼科及电生理、影像学辅助检查。由于缺乏明确的临床指南,其治疗尚无统一的标准。TON的临床治疗包括仅观察及保守治疗、单独使用皮质类固醇治疗或不同方式的视神经减压(使用或不使用类固醇)。本文总结近年文献的主流观点,就TON的病因、损伤机制、诊断、治疗及一些尚处于实验阶段但具备治疗前景的方法等进行综述。Traumatic optic neuropathy(TON)is an acute optic nerve injury that results in severe visual impairment.It is a common complication of craniofacial trauma,which can be direct or indirect,with indirect injuries being more common.In recent years,the incidence rate of TON is on the rise.Once it happens,TON may seriously affect the patient’s quality of life,so early diagnosis and timely treatment are needed.The diagnosis of TON depends on careful ophthalmic examination,including neuro-ophthalmologic observation of the pupils,VEP,OCT,magnetic resonance imagine and other examination.However,due to the lack of clinical guidelines,there is no unified standard for its diagnosis and treatment.The clinical treatment of TON includes only observation and conservative treatment,the use of corticosteroids alone,or optic nerve decompression(with or without steroids).But in clinical practice,there is some controversy about which method is the best of treatment.This article summarizes the mainstream viewpoints of recent literature and provides a review on the etiology,injury mechanism,diagnosis,treatment,and some methods that are still in the experimental stage but have therapeutic prospects for TON.

关 键 词：外伤性视神经病变 诊断 治疗进展 

分 类 号：R774.6[医药卫生—眼科]