Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai.
J Craniofac Surg. 2021 Oct 1;32(7):2479-2483. doi: 10.1097/SCS.0000000000007749.
To assess surgeries with the endoscope-navigation system (ENS) in patients who underwent traumatic optic neuropathy (TON) and find predictors for best corrected visual acuity (BCVA) outcomes.
The clinical data of 96 consecutive TON patients (96 eyes) who underwent decompression surgery with ENS in the Department of Ophthalmology, Shanghai Ninth People's Hospital, from January 2013 to December 2019 were retrospectively reviewed and analyzed. A binary logistic regression was performed to establish a predictive model for BCVA after treatment as TON outcome.
By practicing ENS, 49/96 (51.0%) TON patients got improvement in BCVA, whereas the improvement rate of patients with BCVA of light perception or better was 72.5% (29/40). Hemorrhage within the postethmoid and/or sphenoid sinus, orbital fracture, time interval between trauma and treatment, and BCVA before treatment were predictors for BCVA improvement in TON patients by practicing ENS surgery. The area under raw current curves of the predictive model was 0.826.
Surgeries with the ENS showed positive outcomes for TON patients, especially for those with better BCVA before treatment, shorter time interval between trauma and treatment, without orbital fracture or hemorrhage within the postethmoid and/or sphenoid sinus.
评估内镜导航系统（ENS）在创伤性视神经病变（TON）患者中的手术效果，并寻找与最佳矫正视力（BCVA）结果相关的预测因素。
回顾性分析 2013 年 1 月至 2019 年 12 月上海第九人民医院眼科采用 ENS 进行减压手术的 96 例（96 只眼）TON 患者的临床资料。采用二项逻辑回归分析建立 ENS 治疗后 TON 患者 BCVA 的预测模型。
通过 ENS 手术，49/96（51.0%）的 TON 患者的 BCVA 得到改善，而 BCVA 光感或更好的患者的改善率为 72.5%（29/40）。术后筛窦和/或蝶窦出血、眼眶骨折、创伤与治疗的时间间隔以及治疗前的 BCVA 是 ENS 手术治疗 TON 患者 BCVA 改善的预测因素。预测模型的原始曲线下面积为 0.826。
ENS 手术对 TON 患者有积极的效果，尤其是对治疗前 BCVA 较好、创伤与治疗的时间间隔较短、无眶壁骨折或术后筛窦和/或蝶窦出血的患者。
