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大剂量泼尼松龙对急性视神经炎患者视神经乳头血流的影响。

Effects of high-dose prednisolone on optic nerve head blood flow in patients with acute optic neuritis.

作者信息

Kircher K, Weigert G, Resch H, Garhöfer G, Dorner G T, Fuchsjäger Mayrl G, Reitner A, Schmetterer L

机构信息

Department of Ophthalmology, Medical University of Vienna, Währinger Gürtel 18-20 1090, Vienna, Austria.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2008 Oct;246(10):1423-7. doi: 10.1007/s00417-008-0870-z. Epub 2008 Jun 25.

Abstract

BACKGROUND

In this study, patients with optic neuritis were treated with high-dose prednisolone. Little information is available about the effects of this treatment on ocular blood flow. We set out to investigate the effects of high-dose prednisolone on optic nerve head (ONH) blood flow in patients with acute optic neuritis.

METHODS

Thirteen patients with acute optic neuritis were included in the study. 1000 mg of prednisolone was infused intravenously over 30 minutes on 3 consecutive days. On each study day, ONH blood flow was measured using laser Doppler flowmetry. The ocular hemodynamic measurements were performed on the unaffected eye of the patients with unilateral acute optic neuritis before and immediately after cessation of the infusion. Intraocular pressure (IOP) and systemic blood pressure was measured before and after the infusion on each study day. Data was analyzed using a repeated measures ANOVA model.

RESULTS

Prednisolone increased ONH blood flow in the patients under study (p = 0.04), although the effects were in generally small. No significant change in mean arterial pressure (p = 0.70) or IOP (p = 0.20) could be detected in the patients treated with high-dose prednisolone.

CONCLUSIONS

A small but significant increase in ONH blood flow resulted from infusion of high-dose prednisolone. Further studies are required to investigate whether this effect contributes to the therapeutic efficacy of cortisone in patients with optic neuritis.

摘要

背景

在本研究中,视神经炎患者接受了大剂量泼尼松龙治疗。关于这种治疗对眼部血流的影响,目前几乎没有相关信息。我们着手研究大剂量泼尼松龙对急性视神经炎患者视神经乳头(ONH)血流的影响。

方法

13例急性视神经炎患者纳入本研究。连续3天在30分钟内静脉输注1000mg泼尼松龙。在每个研究日,使用激光多普勒血流仪测量ONH血流。对单侧急性视神经炎患者未受影响的眼睛,在输注停止前和停止后立即进行眼部血流动力学测量。在每个研究日输注前后测量眼压(IOP)和全身血压。使用重复测量方差分析模型分析数据。

结果

泼尼松龙增加了研究中患者的ONH血流(p = 0.04),尽管影响通常较小。在接受大剂量泼尼松龙治疗的患者中,未检测到平均动脉压(p = 0.70)或IOP(p = 0.20)有显著变化。

结论

大剂量泼尼松龙输注导致ONH血流有小幅但显著的增加。需要进一步研究来调查这种效应是否有助于可的松对视神经炎患者的治疗效果。

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