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《Journal of Clinical Emergency》 2019-07
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Clinical effect of medium-dose glucocorticoid therapy in traumatic optic neuropathy patients of medial superciliary arch type and zygomatic type

ZHU Jie;XU Yi;GUO Jian;DING Ning;Department of Emergency,Beijing Tongren Hospital Affiliated to Capital Medical University;  
Objective:To observe the clinical effect of medium-dose glucocorticoid therapy in traumatic optic neuropathy(TON)patients of medial superciliary arch type and zygomatic type.Method:A total of 83 TON patients who met the entry criteria at our hospital from February 2014 to October 2016 were enrolled in this study,and divided into the treatment group and the control group.39 cases of the treatment group were treated with medium-dose corticosteroids(500 mg/d for 3 days,then 40 mg/d for 4 days),combined with neurotrophic drugs.44 cases of the control group were treated with neurotrophic drugs for 7 days.Visual evoked potential(VEP)measurement was carried out in all cases.We evaluated the therapeutic effect with single factor analysis and multiple factors analysis.All patients were followed in Feberary 2019.Result:Single factor analysis revealed:group(P=0.023),vision situation(P=0.001),VEP(P=0.001)and clinic time(P=0.044)had impacts on treatment effect.After revising patients' group,vision situation,VEP and clinic time,OR(95%CI)of vision improved rate of treatment group is 3.351(1.186,9.473)compared with control group;compared to patients with clinic time24 h,patients with clinic time≤24 hcould get better vision improved rate(OR =3.270,95%CI:1.117-9.575).The follow-up time of 2 groups ranged from 28 to 40 months.The median follow-up was 34 months.In the experimental group,there were no significant changes in visual acuity in 23 patients with visual acuity.Among the other 13 patients,1 had visual acuity improved,3 cases descended,9 cases had no change in visual acuity.In the control group,there were no significant changes in visual acuity in 15 patients with visual acuity.Among the other29 patients,2 patients had improved visual acuity,4 patients had decreased and 23 patients had no significant changes in visual acuity.Conclusion:TON patients of medial superciliary arch type and zygomatic type received medium-dose glucocorticoid could get better vision improved rate.However,it is still necessary to increase the sample size and extend the follow-up time for further observation.
【CateGory Index】: R774.6
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