摘要
目的探讨放射性视神经病变(RON)的临床特征及治疗。方法回顾分析1987至2008年我院27例经病史询问、眼底检查、视野、荧光素眼底血管造影(FFA)、B超、核磁共振(MRI)等检查确诊的27例(29只眼)RON患者的临床资料。结果所有病例接受的照射剂量均超过4500厘戈瑞(cGY)。所有病例均表现为单眼或双眼无痛性视力急剧下降。29只眼中,17只眼视乳头外观正常,8只眼苍白色视乳头水肿,1只眼视乳头完全萎缩,1只眼表现为视乳头颞侧苍白。23只眼的FFA显示视乳头及视网膜毛血管无灌注,7只眼在MRI检查时显示视神经或视交叉节段性增大。分别用高压氧、高压氧加光量子照射自血回输、复方樟柳碱治疗,7只眼无效,其余眼视力均有不同程度的改善。结论 RON的发生与肿瘤的部位及照射剂量有关。RON的独特临床表现可为临床及时诊断提供客观依据。诊断一旦确立,可采用高压氧、高压氧加光量子照射自血回输、复方樟柳碱治疗,治疗越早,效果越好。
Objective To investigate the clinical characteristics and therapy of Radiation optic neuropathy（RON）.Methods The clinical data of Radiation optic neuropathy of 27 cases（29eyes） from 1987 to 2008 which were diagnosed by asking about medical history and treatment history,fundus examination,fundus fluorescein angiography（FFA）,MRI,B-ultrasound were retrospectively analyzed.Results All patients received radiation doses in excess of 4500 cGY.All cases manifested as sudden binocular or monocular painless vision decrease.Among the 29 eyes with RON,17eyes with a normal appearance of optic papilla,8 eyes with a pale Color papilledema,1 eye with Complete optic atrophy,1 eye with pale temporal side of the disc.In 23 eyes FFA examination revealed optic disc and retinal capillary non-perfusion.In 7 eyes MRI showed increased segmental optic nerve or chiasm.Among the 29 eyes with Hyperbaric oxygen chamber therapy 、 U1traviolet Blood Irradiation or Compound anisodine,the visual acuity of 22 eyes had improved.Conclusion The occurrence of diseases associated with tumor location and received radiation dose.The unique characteristics of RON supply the objective criteria for the instant clinical diagnosis.RON should be treated timely..Hyperbaric oxygen chamber therapy、 U1traviolet Blood Irradiation or Compound anisodine is a safe and effective approach.
出处
《临床眼科杂志》
2010年第4期361-364,共4页
Journal of Clinical Ophthalmology
关键词
放射性视神经病变
临床特点
治疗
Radiation optic neuropathy
Clinical features
Treatment
