ABSTRACT
Objective:To retrospectively analyze the effect of hormone combined with cerebral glycoside carnosine and dehydration drugs in traumatic optic neuropathy (TON) patients.Methods:The enrolled 215 TON patients in our hospital from February 2014 to September 2021 were randomly divided into the combination group ( n=143) and routine group ( n=142). The baseline data, visual acuity recovery before and after treatment and adverse reactions of each group were compared. Univariate analysis was conducted to analyze the differences in indicators of good prognosis and visual acuity improvement between the two groups. Results:The effective rate of vision recovery in the combination group was significantly increased than that in the routine group ( P<0.05). After treatment, the intraocular pressure and visual field defect in the combination group were significantly decreased than those in the routine group ( P<0.05). Univariate subgroup analysis showed that there were statistically significant differences between TON patients with age ≤40 years, residual light sensation after injury, visit time ≤24 h, and VEP not extinguished with combined treatment of hormone, brain glycoside carnotin and dehydrating drugs and the routine group ( P<0.05). Univariate subgroup analysis showed that TON patients with optic canal fracture without optic nerve swelling and tortuosity had a good prognosis after treatment with combined hormone, cerebral glucoside carnosine and dehydration, which was statistically different from that in the routine group ( P<0.05). Conclusions:Brain glycosides carnosine and dehydration therapy on the basis of combined hormone a prednisolone sodium succinate treatment can improve vision in TON patients, lighten the optic nerve injury, will not increase the occurrence risk of adverse reactions, and have higher security. It is necessary to focus on high-risk patient over 40 years old, more than 24 h of treatment time, VEP extinction, optic nerve swelling poor efficacy. It is worthy of clinical promotion.
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.
