Objective To observe the efficiency and security of enhanced external counter pulsation (EECP) as an adjunctive therapy for nonarteritic anterior ischemic optic neuropathy (NAION). Methods This was a retrospective casecontrol study. Forty-eight patients (48 eyes) with NAION were enrolled in this study. Thirty-two patients (32 eyes) who had been treated with blood vessel dilation and nerve nutrition drugs comprised the medicated group. Sixteen of the patients (16 eyes) in the medicated group were treated with EECP combined with blood vessel dilating and nerve nutrition drugs as EECP group. The differences were not statistically significant between groups in gender(chi;2=0.000), age (t=1.096), course (t=1.613) and visual acuity (chi;2=0.000,P＞0.05). EECP was done once a day, one hour per time, five times a week. Fourteen eyes were treated 12 times EECP and two eyes were treated 36 times EECP within the EECP group. Systemic and ocular side effects were observed during EECP treatment. Corrected visual acuity was examined after treatment and the differences of visual acuity between medicated group and EECP group treated six times and or 12 times with EECP treatment were analyzed. The correlation of visual acuity level, and course, and acuity before treatment were analyzed. A significant improvement in visual acuity was defined as a sustained improvement of three or more visual acuity gradations. An effective of treatment was defined as a sustained improvement of two or less visual acuity gradations. No effective of treatment was defined as visual acuity dropped or showed no progress. Results After six treatments of EECP, within the 16 eyes of EECP group, two eyes achieved significant improvement, five eyes had effective improvement, and nine eyes did not show any improvement. Within the 32 eyes of medicated group, three eyes achieved significant improvement, eight eyes had effective improvement, and 21 eyes did not show any improvement. There was no statistically significant difference in vision between the two groups (chi;2=0.404,P＞0.05). After 12 treatments of EECP, within the 16 eyes of EECP group, six eyes achieved significant improvement, nine eyes had effective improvement, and one eye did not show any improvement. Within the 32 eyes of medicated group, four eyes achieved significant improvement, 10 eyes had effective improvement, and 28 eyes did not show any improvement. The difference was statistically significant comparing the vision level between the two groups (chi;2=11.621,P＜0.05）. The curative effect of patients negatively correlated with course of the disease (r=-0.860，P＜0.05), but positively correlated with visual acuity before treatment (r=1.380,P＜0.05). Skin bruises, hematoma, new retinal bleeding and other side effects did not occur in patients during EECP treatment. Conclusions Many time therapy of EECP can improve vision of NAION patients. There is no local and general complications after a certain number of therapy.
Objective To investigate the related factors of the retinal hemorrhage in high-risk infants (HRI). Methods Eight hundred and sixty HRI with histories of high-risk pregnancy and/or neonatal asphyxia after 1-5 days of birth were enrolled in this study.In 860 cases of HRI, 498 infants were vaginal delivery and 362 infants were delivered through cesarean sections. Among 498 vaginal delivered infants, 407 infants were eutocia and 91 infants were with forceps delivery; 298 infants were born following normal labor, 102 infants experienced prolonged labor, and 98 infants were urgent birth. The retinal hemorrhages were observed and conditions were graded into three degrees of Ⅰ, Ⅱ, and Ⅲ. Conditions of neonatal asphyxia were evaluated based on criteria of Apgar score. The incidence of retinal hemorrhage in the different types of deliveries and labor processes were compared, and the relationship between degree of retinal hemorrhage and grade of neonatal asphyxia were analyzed. Results In 860 cases of HRI, retinal hemorrhages were found in 202 infants (23.5%). Within these 202 infants, 75 infants (37.1%) were Ⅰ degree retinal hemorrhage, 75 infants (37.1%) were Ⅱ degree retinal hemorrhage, and 52 infants (25.8%) were Ⅲ degree retinal hemorrhage. In these 202 infants of retinal hemorrhage, 172 infants (85.1%) had histories of asphyxia; 119 infants (69.2%) were graded as mild asphyxia-risk, and 53 infants (30.8%) were graded as severe asphyxiarisk. There was a statistical difference of the degree of the retinal hemorrhage between the mild and severe asphyxia-risk infants (chi;2=34.61,P＜0.01). The incidence of retinal hemorrhage after vaginal delivery was higher than cesarean section delivery with significant statistical difference (chi;2=30.73,P＜0.01). The incidence of retinal hemorrhage after forceps delivery was significantly higher than eutocia with statistical difference (chi;2=62.78,P＜0.01). Both prolonged and urgent childbirth had statistically significant higher incidences of retinal hemorrhage compared to normal labor in the process of vaginal delivery (chi;2=45.86, 71.51; P＜0.01). Asphyxia, types of delivery, prolonged and urgent labors were risk factors of retinal hemorrhage for HRI (r=7.46,4.87,15.03,6.47;P＜0.01). Conclusions The incidence of retinal hemorrhage in high-risk infant was 23.5%. And, asphyxia, types of delivery, prolonged and urgent labors may play roles of risk factor in retinal hemorrhage of HRI.