Kalábová S, Marešová K, Karhanová M
Cesk Slov Oftalmol. 2020 Spring;76(2):78-87. doi: 10.31348/2020/15.
To ascertain whether various therapeutic procedures in non-arteritic anterior ischaemic optic neuropathy (NAION) have an impact on the resulting visual acuity of the affected eye. To assess the prevalence of risk factors that accompany this disease according to the literature.
The retrospective study enrolled 55 eyes of 53 patients (41 men, 12 women) with an age range of 46 to 85 years (mean 64.9; median 64.0) who were hospitalized at the Department of Ophthalmology of the Faculty of Medicine and Dentistry and the University Hospital in Olomouc with the diagnosis of NAION between 2005 and 2016, and who received systemic treatment with intravenous vasodilators, either alone or in combination with intravenous corticosteroids. Central visual acuity (CVA) prior to treatment and immediately after its termination was evaluated. CVA was measured using the Snellen chart and is presented in decimal values. Using medical history data and medical records, the presence of systemic disease, namely hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, was studied in these patients and evaluated for a possible association with NAION.
In the group of patients who were treated with intravenous vasodilators, the resulting CVA improved by 0.083 on average. In the group of patients who, in addition to vasodilator therapy, also received treatment with corticosteroids, the resulting CVA improved by only 0.03 on average. Although there was a more prominent improvement in CVA in the group treated with intravenous vasodilators alone, this difference was not statistically significant. At least one risk factor was found in the vast majority of the patients (96%). Eighty percent of the patients had hypertension, 43.6% of them were treated for diabetes mellitus, and 72.7% of the patients took drugs for hypercholesterolaemia. A combination of all these conditions was found in 36.4% of the patients. The proportion of smokers and past smokers did not exceed that of non-smokers.
The mean improvement in the resulting CVA in patients after systemic therapy with vasodilators alone was greater than in those treated with a combination of vasodilators and corticosteroids; however, this difference was not statistically significant. In most patients in the group, at least one systemic risk factor was noted, most frequently hypertension. The prevalence rate of systemic risk factors was comparable to that reported in the literature.
确定非动脉炎性前部缺血性视神经病变（NAION）的各种治疗方法是否会对患眼最终的视力产生影响。根据文献评估伴随该疾病的危险因素的患病率。
这项回顾性研究纳入了53例患者的55只眼（41例男性，12例女性），年龄在46至85岁之间（平均64.9岁；中位数64.0岁），这些患者于2005年至2016年期间在奥洛穆茨医学院和牙科学院眼科以及大学医院住院，诊断为NAION，并接受了静脉血管扩张剂的全身治疗，单独使用或与静脉皮质类固醇联合使用。评估治疗前及治疗结束后即刻的中心视力（CVA）。使用斯内伦视力表测量CVA，并以小数形式呈现。利用病史数据和病历，研究这些患者中全身性疾病（即高血压、2型糖尿病和高胆固醇血症）的存在情况，并评估其与NAION的可能关联。
在接受静脉血管扩张剂治疗的患者组中，最终的CVA平均提高了0.083。在除血管扩张剂治疗外还接受皮质类固醇治疗的患者组中，最终的CVA平均仅提高了0.03。尽管单独接受静脉血管扩张剂治疗的组中CVA改善更为显著，但这种差异无统计学意义。绝大多数患者（96%）至少发现一种危险因素。80%的患者患有高血压，其中43.6%接受糖尿病治疗，72.7%的患者服用治疗高胆固醇血症的药物。36.4%的患者存在所有这些情况的组合。吸烟者和既往吸烟者的比例未超过非吸烟者。
单独使用血管扩张剂进行全身治疗的患者最终CVA的平均改善大于联合使用血管扩张剂和皮质类固醇治疗的患者；然而，这种差异无统计学意义。该组中的大多数患者至少存在一种全身性危险因素，最常见的是高血压。全身性危险因素的患病率与文献报道相当。
