Study of early effect and safety of medium-dose glucocorticoid therapy in patients with traumatic optic neuropath / 中华急诊医学杂志

ABSTRACT

Objective:To observe the clinical early effect and safety of medium-dose glucocorticoid therapy in patients with traumatic optic neuropathy (TON).Methods:A total of 150 TON patients who met the entry criteria at our hospital from May 2015 to December 2018 were enrolled into our study and divided into the treatment group and the control group according to the treatment, 75 cases in each group. Patients in the control group were treated with dehydration, neurotrophy. Patients in the treatment group were added medium-dose corticosteroids 500 mg/d for 3 days, and then reduced to 40 mg/d for 4 days on the basis of the control group. All the patients were treated with 7 days, and visual evoked potential (VEP) measurement was carried out in all cases. The efficacy and safety based on the changing of visual acuity were evaluated.Results:The effective rate of the treatment group was 44.28% (31/70), and of control group was 26.47% (18/68), with statistically significant difference ( χ2=0.471, P<0.05); Subgroup analysis indicated that when age, visual acuity or VEP change were taken as stratification factors, differences in effective rates between the two groups were statistically significant ( P<0.05). Patients' age less than 50 years ( OR=2.649), visual acuity light perception ( OR=3.590) or VEP showing no wave ( OR=3.700) were the dominant population. The incidence of adverse drug reactions in the treatment and control groups were 13.89% (10/70) and 11.27%(8/68) respectively, and the difference was not statistically significant (χ 2=0.223, P>0.05). Conclusions:Patients who receive a medium-dose glucocorticoid after traumatic optic neuropathy gain better visual acuity.