Pakravan Mohammad, Esfandiari Hamed, Hassanpour Kiana, Razavi Sarvnaz, Pakravan Parastou
a Ophthalmic Epidemiology Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
b Ophthalmic Research Center , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
Curr Eye Res. 2017 Jul;42(7):1079-1084. doi: 10.1080/02713683.2016.1270328. Epub 2017 Feb 26.
To investigate the effect of combined intravenous (IV) erythropoietin (EPO) and corticosteroid as well as systemic steroid alone for the treatment of non-arteritic anterior ischemic optic neuropathy (NAION).
In this prospective interventional comparative case series, 113 consecutive patients diagnosed with recent onset (less than 14 days) NAION were included. Patients were categorized into three groups. 40 patients received systemic IV corticosteroid combined with recombinant human erythropoietin (rhEPO) (group 1), 43 patients received systemic corticosteroid alone (group 2), and 30 patients were enrolled as the control group (group 3). Functional and structural outcomes were analyzed 3 and 6 months after treatment. Best corrected visual acuity (BCVA) was the main outcome, and mean deviation (MD) and peripaillary retinal nerve fiber layer thickness (PRNFLT) were secondary outcome measures.
The mean BCVA at the time of presentation was 0.98 (±0.65), 0.96 (±0.67), and 1.02 (±0.63) log MAR in groups 1, 2, and 3, respectively (P = 0.95). At month 3, the corresponding values were 0.73 (±0.45), 0.76 (±0.49), and 0.8 (±0.45) log MAR (P = 0.80), and at the 6-month follow-up, they were 0.76 (±0.45), 0.71 (±0.4), and 0.71 (±0.46) log MAR, respectively (P = 0.87). There was no statistically significant difference in BCVA between months 3 and 6, which implies stabilization of the visual acuity by month 3. Considering the visual field, within 6 months of follow-up after disease onset, the MD index improved in all groups with no statistically significant differences between them (P = 0.82). PRNFLT at presentation was 178 (±60), 186 (±59), and 166 (±57) micrometers in groups 1, 2, and 3, respectively (P= 0.99), which decreased to 77 (±16), 83 (±22), and 73 (±11), respectively, at final visit (P = 0.14) Conclusion: We found no beneficial effect of either systemic steroid alone or combined with EPO in the visual outcome of NAION patients.
探讨静脉注射促红细胞生成素（EPO）联合皮质类固醇以及单独使用全身皮质类固醇治疗非动脉炎性前部缺血性视神经病变（NAION）的效果。
在这个前瞻性干预性对比病例系列研究中，纳入了113例近期发病（少于14天）的NAION连续患者。患者被分为三组。40例患者接受全身静脉注射皮质类固醇联合重组人促红细胞生成素（rhEPO）（第1组），43例患者仅接受全身皮质类固醇治疗（第2组），30例患者作为对照组（第3组）。在治疗后3个月和6个月分析功能和结构结果。最佳矫正视力（BCVA）是主要结果，平均偏差（MD）和视乳头周围视网膜神经纤维层厚度（PRNFLT）是次要结果指标。
第1组、第2组和第3组就诊时的平均BCVA分别为0.98（±0.65）、0.96（±0.67）和1.02（±0.63）log MAR（P = 0.95）。在第3个月时，相应的值分别为0.73（±0.45）、0.76（±0.49）和0.8（±0.45）log MAR（P = 0.80），在6个月随访时，分别为0.76（±0.45）、0.71（±0.4）和0.71（±0.46）log MAR（P = 0.87）。第3个月和第6个月时BCVA无统计学显著差异，这意味着到第3个月时视力稳定。考虑视野，在疾病发作后的6个月随访内，所有组的MD指数均有所改善，组间无统计学显著差异（P = 0.82）。第1组、第2组和第3组就诊时的PRNFLT分别为178（±60）、186（±59）和166（±57）微米（P = 0.99），在最后一次就诊时分别降至77（±16）、83（±22）和73（±11）微米（P = 0.14）。结论：我们发现单独使用全身皮质类固醇或联合EPO对NAION患者的视力结果均无有益影响。
