Hansen L L, Wiek J, Danisevskis M, Schrader W
Universitäts-Augenklinik, Freiburg, Bundesrepublick Deutschland.
Fortschr Ophthalmol. 1991;88(5):487-9.
As there is no generally accepted treatment for non-inflammatory anterior ischemic optic neuropathy, we have started a randomized, controlled clinical trial on isovolemic hemodilution. In this study all patients received a basic treatment of 75 mg of acetylsalicyclic acid daily. Patients were then randomly assigned to either a group without additional therapy or a group with isovolemic hemodilution. Isovolemic hemodilution was carried out over 6 weeks by several blood-letting procedures and replacement of volume by infusion of hydroxyethyl starch solutions (PCV down to 35-32%). So far, 21 patients have fulfilled the inclusion criteria (symptoms less than or equal to 30 days, no medical contraindications, no giant-cell arteritis), and since they matched for age, duration of symptoms, cardiovascular risk factors, they could be observed for at least 3 months. Although only 1 of 10 control patients hat better visual acuity after 3 months; 6 out of 11 hemodiluted patients had better vision after treatment (p = 0.024). These results indicate that isovolemic hemodilution most likely has a beneficial effect on the visual prognosis of patients with anterior ischemic neuropathy.
由于目前尚无针对非炎性前部缺血性视神经病变的公认治疗方法，我们开展了一项关于等容血液稀释的随机对照临床试验。在本研究中，所有患者均接受每日75毫克乙酰水杨酸的基础治疗。然后将患者随机分为两组，一组不接受额外治疗，另一组接受等容血液稀释治疗。通过多次放血程序及输注羟乙基淀粉溶液补充血容量（使血细胞比容降至35%-32%），进行为期6周的等容血液稀释。到目前为止，已有21名患者符合纳入标准（症状持续时间小于或等于30天，无医学禁忌证，无巨细胞动脉炎），且由于他们在年龄、症状持续时间、心血管危险因素方面相匹配，故可对其进行至少3个月的观察。尽管3个月后，10名对照患者中只有1名视力有所改善；但11名接受血液稀释治疗的患者中有6名治疗后视力改善（p = 0.024）。这些结果表明，等容血液稀释很可能对前部缺血性视神经病变患者的视力预后具有有益作用。
