在内透鼻中介轨道减压后,在活跃和非活跃的甲状腺障碍视觉神经病变中,手术效果的比较
1Department of Orbital Diseases and Ocular Oncology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
概括
内镜轨道减压通过减少眼外肌肉体积比例,改善了双甲状腺视神经病变 (DON) 患者的视力. 活跃的DON患者在手术后显示出更大的视觉功能改善.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 手术创新 在外科创新.
背景情况:
- 甲状腺视神经病变 (DON) 由于轨道软组织的变化,显著影响视觉功能.
- 医疗管理,包括类固醇,对于DON并不总是有效的.
- 轨道减压是一种手术选择,以减轻视神经的压缩.
研究的目的:
- 为了比较轨道软组织体积和视觉功能的变化后内透鼻中介轨道解压在活跃与非活跃的DON.
- 为了评估这种手术方法在DON的不同阶段的疗效.
主要方法:
- 一项针对112名DON患者的前性队列研究,分为活跃 (56只眼睛) 和不活跃 (56只眼睛) 组.
- 在所有患者身上进行了内透鼻中介轨道减压.
- 轨道软组织体积 (使用CT和Mimics软件) 和视觉功能 (BCVA,VF,VEP) 在手术前和后被测量.
主要成果:
- 在手术前,活跃的DON显示出更高的眼外肌肉体积 (EMV) 和EMV/轨道体积 (OV) 比率,视觉功能更差.
- 在手术后,EMV/OV比率在两组都下降,表明肌肉比例减少.
- 视觉功能 (BCVA,VF,VEP) 和外眼在活跃和不活跃的DON组都得到改善,在手术后的组之间没有显著差异.
结论:
- 通过降低EMV/OV比率,轨道减压有利于无反应类固醇的DON患者,无论疾病活动如何.
- 与不活跃的DON患者相比,活跃的DON患者的视觉功能得到了更显著的改善.
- 透鼻内透鼻中间轨道去压是一种有效的治疗方法,用于改善DON的视觉功能.
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