Tsai Hui-Hong, Jeng Seng-Feng, Lin Tsan-Shiun, Kueh Nai-Siong, Hsieh Ching-Hua
Department of Neurology, Chang Gung Memorial Hospital in Kaohsiung, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.
Clin Neurol Neurosurg. 2005 Apr;107(3):200-6. doi: 10.1016/j.clineuro.2004.07.015.
The visual outcome of 39 patients who had unilateral indirect type traumatic optic neuropathy and periorbital facial bone fracture treated at the Chang Gung Memorial Hospital in Kaohsiung between June 1996 and June 2001 was retrospectively evaluated, based on the results of computed tomography studies that grouped the associated fractures as anterior orbital fracture, posterior orbital fracture, orbital blow-in or blow-out fracture. Pretreatment and posttreatment visual acuities were obtained from the medical records and measurements of visual improvement degree and percentage were calculated after converting the visual acuities into log of the minimum angle of resolution (log MAR) units. This study reveals that posterior orbital fracture is associated with a worse prognosis in visual outcome than anterior orbital fracture, with visual improvement degree and percentage being 0.86 +/- 0.17 log MAR and 34.2 +/- 1.7% versus 1.56 +/- 0.27 log MAR and 58.9 +/- 1.7%, respectively (P = 0.02 and 0.004). Blow-in fractures such as an impacted lateral orbital wall did not predict significant deterioration in visual outcome. In addition, orbital floor or medial wall blow-out fractures did not predict significant improvement in visual outcome.
回顾性评估了1996年6月至2001年6月在高雄长庚纪念医院接受治疗的39例单侧间接型外伤性视神经病变合并眶周面部骨折患者的视觉预后，这些评估基于计算机断层扫描研究结果，该研究将相关骨折分为眶前部骨折、眶后部骨折、眶内陷或眶爆裂骨折。从病历中获取治疗前和治疗后的视力，并将视力转换为最小分辨角对数（log MAR）单位后，计算视力改善程度和百分比。本研究表明，与眶前部骨折相比，眶后部骨折的视觉预后更差，视力改善程度和百分比分别为0.86±0.17 log MAR和34.2±1.7%，而眶前部骨折分别为1.56±0.27 log MAR和58.9±1.7%（P = 0.02和0.004）。诸如外侧眶壁骨折等眶内陷骨折并未预示视觉预后会显著恶化。此外，眶底或眶内侧壁爆裂骨折也未预示视觉预后会显著改善。
