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1、急性视神经炎临床特征和疗效分析【摘要】廿的：观察和分析54例⑻眼)急性视神经炎患者资料，探讨其临床特点和治疗效果。方法:冋顾性研究199610/200710入住我科的急性视神经炎患者54例(81眼)的发病原因、视力、瞳孔运动障碍、眼底、视野和视诱发电位(visualevokedpotentiatVEP)的改变，治疗效杲和预肩。结杲：急性视神经炎发病原因较多，其中多发性换化占9%,瞪孔运动障碍者占63%,以相对瞄孔传导阻滞(relativeafferentpapillarydefect,RAPD)
2、为主。急性视神经乳头炎(acuteneuropapillitis)患者眼底均有不同程度的改变。视功能损害严重，视野表现多种改变，以中心暗点多见，占78%。VEP异常率高，以潜伏期延长为主，占73%o采用以静脉滴注甲基强的松^(intravenousmethylprednisolone,IVMP)为主的综合治疗后，患者视力显著提高，治愈率为62%,总有效率为93%o治疗效果与发病原因、视神经炎分型无关，与就诊时间有关，就诊时间越快，治疗效果越好。结论：急性视神经炎发病原因多样，视功能损害重，但治疗
3、效果较好，及时诊断和治疗是提高视功能的关键。【关键词】急性视神经炎；多发性换化；病因；甲基强的松龙；疗效；ClinicalfeaturesandtreatmentofacuteopticneuritisYuQingLan,ChiZhang,ZhaoXiaXia,WeiPeng,JianHuiXiaoDepartmentofOphthalmology,theSecondAffiliatedHospitalofSunYatsenUniversity,Guangzhou510120,Guangdong
4、Province,ChinaCorrespondenceto:YuQingLan・DepartmentofOphthalmology,theSecondAffiliatedHospitalofSunYatsenUniversity,Guangzhou510120,GuangdongProvince,China.lyqglp@163.comAbstractAIM:Tosurveytheclinicalcharacteristicsandthetherapeuticeffectofacuteopti
5、cneuritis(AON).METHODS:Fiftyfourcases(81eyes)ofAONhospitalizedfromOctober1996toOctober1997wereretrospectivelyanalyzedinetiology,visualacuity,disturbanceofpupilmovement,changesoffundus,visualfieldandVERcurativeeffectandprognosis.RESULTS:Theseveredamag
6、eofvisualfunctionandvariouscauseswerefoundinAONofwhichmultiplesclerosis(MS)accountedfor9%・Disturbanceofpupilmovementwas63%inwhichrelativeafferentpapillarydefect(RAPD)werethemostcommon(78%).Abnormalchangeswerefoundintheocularfundusforallthepatientswit
7、hpapillitisoptica・Visualfieldhaddifferentmanifestation,andcentralscotomawasthemostcommon(78%).AbnoimalrateofVEPwashighandunusualPlatencywasin73%.Withinintravenousmethylprednisolone(IVMP)andothersynthetictreatment,theturativerateofAONreachedto62%andth
8、eeffectiveratewas83%・CurativeeffectwasntrelatedwiththecausesandtypesoftheAON.Instead,thefastertogetthetreatment,thebetterthecurativeeffectwouldbe.CONCLUSION:VisualfunctionofAONisdamagedheavily,butcurativeeffectissatisfied.Promptdiagnoseandtreatmentar
