[1]万超,柳力敏,赵宁,等.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[J].眼科新进展,2015,35(1):048-50.[doi:10.13389/j.cnki.rao.2015.0014]
　WAN Chao,LIU Li-Min,ZHAO Ning,et al.Visual field defect and therapeutic effect of glucocorticoid and neurotrophy treatment on uninjured side Eye in eyeball rupture patients[J].Recent Advances in Ophthalmology,2015,35(1):048-50.[doi:10.13389/j.cnki.rao.2015.0014]
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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
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年1期
页码:
048-50
栏目:
应用研究
出版日期:
2015-01-05

文章信息/Info

Title:
Visual field defect and therapeutic effect of glucocorticoid and neurotrophy treatment on uninjured side Eye in eyeball rupture patients
作者:
万超; 柳力敏; 赵宁; 刘宁宁; 才娜; 陈蕾
１１０００１　辽宁省沈阳市，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
Author(s):
WAN Chao ;  LIU Li-Min ;  ZHAO Ning ;  LIU Ning-Ning ;  CAl Na ;  CHEN Lei
Department of Ophthalmology, the First Hospital of China Medical University, China Medical University Eye Center, Shenyang llOOOl, Liaoning Province，China
关键词:
眼球破裂伤; 视野; 平均缺损; 模式标准差; 视神经保护
Keywords:
eyeball rupture ;  visual fields ;  mean deviation ;  pattern standard deviation ;  optic neuroprotection
DOI:
10.13389/j.cnki.rao.2015.0014
文献标志码:
A
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。
Abstract:
Objective To observe the variation of visual field and therapeutic effects of glucocorticoid and neurotrophy treatment on the uninjured side eye after eyeball 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 6 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. 63 + 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 ternunal stage ; There were statistical differences between those of before and after treatment (P < 0. 01) . Conclusion The uninjured side eye of eyeball rupture patient present decreased visual acuity and visual field damage , glucocorticoid and neurotrophic pharmacotherapy can improve them , for patients with eyeball rupture,more attention should be paid to the uninjured eye.

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更新日期/Last Update: 2015-01-04