Stammen J, Unsöld R, Arendt G, Vester E G, Heering P, Freund H, Strauer B, Grabensee B
Department of Ophthalmology, University of Düsseldorf, Germany.
Ophthalmologica. 1999;213(1):40-7. doi: 10.1159/000027392.
A nonrandomized, prospective, interdisciplinary pilot study of 102 patients with noncompressive optic disc swelling with visual loss (ODSWVL) was performed in order to investigate etiologic and pathogenetic mechanisms. Forty-six patients suffered from underlying inflammatory disease. Seventeen patients suffered from highly probable cardiogenic embolization, 16 patients from multiple vascular risk factors. The remaining patients of the noninflammatory disease group suffered from leukemia, previously unknown or severely decompensated diabetes mellitus, acute arterial hypertension, different kinds of coagulopathies and others. Ninety-six of the 102 patients required medical treatment according to general medical standards. Inhomogeneity of the underlying disease processes explains the ineffectiveness of different monotherapies in previous studies. Interdisciplinary search for the underlying causes allows causative treatment. ODSWVL and anterior ischemic optic neuropathy in particular seem to be a common final pathway of various pathogenetic mechanisms due to different etiologies rather than a disease entity by itself.
为了研究病因和发病机制，对102例非压迫性视神经盘肿胀伴视力丧失（ODSWVL）患者进行了一项非随机、前瞻性、多学科的试点研究。46例患者患有潜在的炎症性疾病。17例患者患有高度可能的心源性栓塞，16例患者有多种血管危险因素。非炎症性疾病组的其余患者患有白血病、先前未知或严重失代偿的糖尿病、急性动脉高血压、各种凝血障碍等。102例患者中有96例需要根据一般医疗标准进行治疗。先前研究中不同单一疗法无效的原因是潜在疾病过程的异质性。多学科寻找潜在病因有助于进行病因治疗。ODSWVL，尤其是前部缺血性视神经病变，似乎是由不同病因导致的各种发病机制的共同最终途径，而不是一种独立的疾病实体。
