■作为老年患者最常见的急性视神经病变,非动脉炎性前部缺血性视神经病变(NAION)表现为不同程度的视力丧失和视野缺损。然而,没有公认的NAION治疗方法。
■评估2个月内富血小板血浆(PRP)对急性NAION患者的疗效和安全性。
■预期,非随机对照试验。
■纳入25例患者的25只眼。其中,对照组13例给予氢溴酸樟柳碱丁苯酞氯化钠注射液连续10天作为基础治疗,在PRP组中,12人间隔10天接受两次Tenon胶囊注射PRP作为额外治疗.我们比较了第一次PRP治疗前1天(D1)和7天(D7)时,放射状乳头周围毛细血管的最佳矫正视力(BCVA)和毛细血管灌注密度(CPD)以及乳头周围浅表毛细血管丛和深毛细血管丛的蛾食耳朵,14天(D14),以及第一次PRP注射后30天(D30)。评估眼部和全身不良反应。
■在PRP组中,一个更好的BCVA发生在D30(调整p=0.005,与D1相比,从0.67±0.59恢复到0.43±0.59),并且在D30观察到CPD的显着改善(与D1,D7,D14顺序相比,调整后的p<0.001,p=0.027,p=0.027,分别为35.97±4.65、38.73±4.61、39.05±5.26、42.71±4.72)。PRP组在D7时的CPD优于对照组(p=0.043)。然而,两组间BCVA和蛾食面积指数均无显著差异(均p>0.5)。主要不良反应为1周内局部不适消退,无其他系统性不良事件发生.
■Tenon胶囊注射PRP是AION的安全治疗方法,可以改善视神经乳头的毛细血管灌注,可能有助于增加急性NAION患者的短期视力。
As the most common acute optic neuropathy in older patients, nonarteritic anterior ischemic optic neuropathy (NAION) presents with varying degrees of visual acuity loss and visual field defect. However, there is no generally accepted treatment for NAION.
To evaluate the efficacy and safety of platelet-rich plasma (PRP) for patients with acute NAION within 2 months.
A prospective, nonrandomized controlled trial.
Twenty-five eyes of 25 patients were enrolled. Of them, 13 received anisodine hydrobromide and butylphthalide-sodium chloride injection continuously for 10 days as basic treatment in the control group, and 12 received two tenon capsule injections of PRP on a 10 days interval as an additional treatment in the PRP group. We compared the best-corrected visual acuity (BCVA) and capillary perfusion density (CPD) of radial peripapillary capillaries and the moth-eaten eara of the peripapillary superficial capillary plexus and deep capillary plexus at 1 day (D1) before the first PRP treatment and 7 days (D7), 14 days (D14), and 30 days (D30) after the first PRP injection. Ocular and systemic adverse effects were assessed.
In the PRP group, a better BCVA occurred at D30 (adjusted p = 0.005, compared with D1, recovered from 0.67 ± 0.59 to 0.43 ± 0.59), and a significant improvement in CPD was observed at D30 (adjusted p < 0.001, p = 0.027, p = 0.027, compared with D1, D7, D14, in sequence, the value was 35.97 ± 4.65, 38.73 ± 4.61, 39.05 ± 5.26, 42.71 ± 4.72, respectively). CPD at D7 in the PRP group was better than that in the control group (p = 0.043). However, neither BCVA nor the moth-eaten area index were significantly different (all p > 0.5) between the two groups. The main adverse effect was local discomfort resolved within 1 week, and no other systemic adverse events occurred.
Tenon capsule injection of PRP was a safe treatment for AION and could improve capillary perfusion of the optic nerve head and might be helpful in increasing short-term vision in patients with acute NAION.