Visual prognosis after indirect traumatic optic neuropathy
Visual prognosis after indirect traumatic optic neuropathy
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DOI：
10.1136/jnnp.74.2.246
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发表时间：
2003-02-01
影响因子：
11
通讯作者：
Carta, F
中科院分区：
文献类型：
--
作者：
Carta, A;Ferrigno, L;Carta, F
目的：探讨间接外伤性视神经病变患者的最终视力与基线时各种全身和局部（眶/眼）体征的可能相关性。方法：对35例外伤性视神经病变进行回顾性分析，并对13项指标进行检验。以“视力未恢复”为主要结果进行单因素分析。计算相对危险度（RR）和95%置信区间（CI）。费雪精确检验用于两个变量来检验比例之间的差异。结果：四个变量显示视力无法恢复的风险显著增加：后筛细胞内存在血液（RR = 2.25, 95% CI 1.25 ~ 4.04）；40岁以上（RR = 1.79, 1.07 ~ 2.99）；意识丧失与外伤性视神经病变相关（RR = 2.21, 1.17 ~ 4.16）；类固醇治疗48小时后的恢复情况（p < 0.01， Fisher精确检验）。治疗后第一次随访记录的康复与最后一次随访记录的康复显著相关（p < 0.01， Fisher精确检验）。结论：外伤性视神经病变患者的这四种不良预后体征可能有助于预测头部外伤后视力丧失患者的视力结局，并决定是否需要手术治疗。
Objective: To investigate a possible correlation between final visual acuity and the presence at baseline of various systemic, and local (orbital/ocular) signs in patients affected by indirect traumatic optic neuropathy.Methods: 35 cases of traumatic optic neuropathy were examined retrospectively and 13 variables were tested. Univariate analysis with "no recovery of visual acuity" as the primary outcome was performed. Relative risk (RR) and 95% confidence intervals (CI) were calculated. Fisher's exact test was used for two variables to test differences between proportions.Results: Four variables showed a significantly increased risk for no recovery of visual acuity: presence of blood within the posterior ethmoidal cells (RR = 2.25, 95% CI 1.25 to 4.04); age over 40 years (RR = 1.79, 1.07 to 2.99); loss of consciousness associated with traumatic optic neuropathy (RR = 2.21, 1.17 to 4.16); and abscence of recovery after 48 hours of steroid treatment (p < 0.01, Fisher's exact test). Recovery documented at the first follow up visit after treatment was significantly associated with recovery at the last follow up visit (p < 0.01, Fisher's exact test).Conclusions: These four negative prognostic signs in patients affected by traumatic optic neuropathy may be useful in predicting the visual outcome in patients developing visual loss after head trauma and in deciding on the need for surgical treatment.