Objective To evaluate the clinical efficacy of oral calcium dobesilate(CaD) on diabetic optic neuropathy (DON).Methods The clinical data of 235 eyes of 235 patients with DON diagnosed by examination of ocular fundus were retrospectively analyzed.The patients were divided into 3 groups according to the subtypes of DON: anterior ischemic optic neuropathy(AION)group(71 eyes of 71 patients), papilloedema group (71 eyes of 71 patients),and neovascularization of disc (NVD) group (93 eyes of 93 patients).The patients in each groups were randomly subdivided into CaD treating group and control group, in which the patients underwent oral administraion of CaD at a dose of 500 mg twice per day or Vit.E at a dose of 10 mg twice per day,respectively.The course of therapy was 6 months and consecutive 2 courses were performed with the 3-4 days interval between the courses; the courses lasted for 6 months.Several parameters (VFD/V),EA/d,NA/d,LA/d) were semiquantitative analyzed 2,4,6,8 months after initial treatment. Repeated ANOVA measures and t test were used as statistical methods.Results In CaD group,VFD/V (0.25plusmn;0.10),EA/d (0.94plusmn;0.53), and LA/d(1.83plusmn;1.12) 2 months after initial treatment was obviously better than the results before the treatment (0.49plusmn;0.13,1.57plusmn;0.71,3.42plusmn;1.88)(P＜0.001), respectively.VFD/V,EA/d and LA/d in CaD group 2,4,6,and 8 months after initial treatment significantly differed from which in the control group (P＜0.01). There was significant difference of VED/V,EA/d,and LA/d between the CaD and control group during the follow-up period (P＜0.01).At each time point in the followup period, there was no significant difference of NA/d among groups and between the treating and control group (P＞0.05).Conclusion Oral administration of CaD can rapidly and remarkably decrease the extent of visual field defect,relieve optic disc edema and lessen the leakage of NVD.
Objective To observe the therapeutic effect of ai-weizhi on anterior ischmic optic neuropathy (AION). Methods In 58 patients (60 eyes) who were diagnosed as with AION, 29 patients (30 eyes) underwent intravenous drip with ai-weizhi (1200 mg/d) (treatment group), and the other 29 patients (30 eyes) underwent intravenous drip with 1-2 kinds of thrombolytic coagulant or vasodilator (once per day) (control group) with the period of treatment of 15 days. In the control group, ocular local injection, including gluco-corticosteroid and 654-2 behind or beside the eyeball injected once per day or every 2 days for 3-5 times, was perfomed on 20 eyes simultaneously. The changes of visual acuity and ocular fundus of the patients after injection were recorded, and the visual field was counterchecked in the patients who had underwent the examination before the treatment. Results The visual acuity was better in treatment group than which in control group with a significant difference (t=2.74, Plt;0.01). The visual acuity in treatment group didnprime;t differ much from which in the control group 3 days after treatment (t=1.34, P＞0.05). At the 5th、10th and 15th day after treatment, the visual acuity was better in treatment group than which in control group with a significant difference(t=2.01, Plt;0.05; t=2.07, Plt;0.05；t=2.74, Plt;0.01). In 15 eyes in control group which had undergone examination of visual field, the visual field improved in 13 (87.00%) and of remained still in 2 (13.00%). In 13 eyes in treatment group which had undergone examination of visual field, the visual field improved in 4 (31.00%) and remained still in 9 (69.00%). There was a significant difference between the two groups (chi;2=9.66, Plt;0.01). Conclusion Ai-weizhi is efficacious in treatment of AION. (Chin J Ocul Fundus Dis, 2006, 22: 97-99)
Objective To evaluate the treatment of surgery and high-dose corticosteroid relevant factors to prognosis in traumatic optic neuropathy. Methods Forty patients(40 eyes) with traumatic optic neuropathy were enrolled.Optic nerve decompression using transcranial approaches,sinus endoscopy and orbital-ethmoidal sinus rout were performed in 14 patients.Eleven patients were treated with high-dose corticosteroids (5 cases with 1 mg/kg dexamethasone,6 cases with 30 mg/kg methylprednisolone) and 15 patients received nonspecific management chose by themselves.The outcomes of visual acuity in short term and final stage were compared between surgery,high-dose corticosteroid and nonspecific treatment.Multiple variable analysis was done to determine the factors affecting the outcome of visual acuity. Results No light perception were found in 19 cases (19 out of 44 cases,47.5%),whereas visual acuity was light perception to 0.02 in 12 cases (30.0%) and 0.05 or better in 9 cases (22.5%).The odds ratio of high-dose corticosteroid to nonspecific therapy was 2.96 (P=0.0125).The final visual acuity in patients treated with high-dose corticosteroid were better than other two groups (P=0.005,P=0.023,respectively).The short term (within 3 days) effective rate was higher in corticosteroid therapy group than operated group (P=0.024).No light perception following optic nerve trauma appeared to be more danger as 2.14 folds (P=0.0349) than those with light perception or better in term of final visual acuity outcome. Conclusions High-dose corticosteroid may be benefit to traumatic optic neuropathy.The treatment in traumatic optic neuropathy using optic nerve decompression needs to be determined.No light perception at initial is an important risk factor in the outcome. (Chin J Ocul Fundus Dis,2000,16:75-77)
Objective To investigate the effects and the safety of compound anisodine injection on treatment of primary and secondary ischemic optic neuropathy and choroidoretinopathy. Methods A multicentered,random,controlled study was applied on 403 patients,including 217 patients of primary ischemic optic neuropathy and choroidoretinopathy,and 186 patients of secondary ischemic optic neuropathy and choroidoretinopathy.All the patients were assigned into 3 groups randomly:112 patients in control group and treatment group respectively,179 patients in open group.Compound anisodine 2 ml was injected subcutaneously around superficial temporal artery to the patient in treatment and open group once every day,while tolazoline 25 mg was given in the same way to the patient in control group for 21 days.Visual acuity,visual field and fundus condition are examined to evaluate the effects of treatment,and intraocular pressure,blood pressure,electrocardiography,blood and urine routine examination,blood test for renal and liver function are taken to study the safety of the treatment.The main subjects of the control and treatment group before treatment were comparable (Pgt;0.05) Results The difference of effective rate between treatment group (82.14%) and control group (36.61%) was significant (chi;2=48.14,P=0.0000).The effective rate of open group is 80.45%.The effects on both primary and secondary patients in treatment group (87.04% and 77.59%) were better than those in control group (35.19% and 37.93%),and the difference was significant (P=0.0000) .The difference of the results in different centers was not significant according to Ridit analysis.There was few side effect except temporary dry mouth in some patients and the parameters of safety had no significant change before and after treatment. Conclusion Compound anisodine is a safe and effective drug to treat primary and secondary ischemic optic neuropathy and choroidoretinopathy. (Chin J Ocul Fundus Dis,2000,16:71-74)
Objective To observe in vitro the protective effect of cranial nerve growthine (CNG) on the optic nerve injured by acute ocular hypertension. Methods Thirty white rabbits were divided into five groups,and 6 in each.The acute ocular hypertension(50 mm Hg) models were established by forcing perfusion of normal saline solution into the anterior chamber sustained for 6 h in one eye,and the contral ateral eye of each rabbit was regard as control.Three rabbits in each group were then treated by CNG 0.2 ml intramuscularly every day.The optic nerve and retina was surgically removed at five different time points (lst,3rd,7th,15th and 30th day) after operation.With the HRP orthograde tracing technique and transmitted electron microscope,the effect of CNG on the optic nerve was observed by the changes of axonal transport and ultrastructure of optic nerve. Results Compare with experimental control groups (25.17plusmn;1.03),HRP reactive products of treated groups (39.79plusmn;2.29) markedly increased after seven days (Plt;0.01).The degeneration of axons in treated groups was relatively lighter after fifteen days and some axons recovered after thirty days. Conclusion CNG might improve the axonal transport and the recovery of axons after the optic nerve injured by acute ocular hypertension. (Chin J Ocul Fundus Dis,2000,16:88-90)