一个20年的多中心追溯审查视神经外 fenestration的结果
Shaddy El-Masri1,2, Matthew Wilson3, Jonathan Goh3
1Royal Melbourne Hospital, Hospital City Campus, Grattan Street, Parkville, VIC 3050, Australia.
Therapeutic advances in neurological disorders
|September 18, 2023
概括
视神经膜化 (ONSF) 是有效的视力损失高内压力 (ICP) 由于异常性内高血压 (IIH) 或大脑静脉鼻血栓塞 (CVST). 这种手术可以改善视力,特别是当其他治疗方法失败时.
科学领域:
- 眼科医生 眼科 眼科
- 神经外科 神经外科
- 神经学 神经学
背景情况:
- 视神经窗 (ONSF) 对内压升高 (ICP) 的纵向结果尚未得到充分确立.
- 在ONSF上,除了异常发病性内高血压 (IIH) 之外,对于ICP的原因存在有限的数据.
研究的目的:
- 评估ONSF在IIH患者,脑静脉鼻血栓 (CVST) 和其他导致ICP升高的患者的疗效和安全性.
- 为了评估视觉敏度,视野和视觉神经的外观,ONSF.
主要方法:
- 从2000年至2020年期间接受ONSF的70名患者116只眼睛的回顾性审查.
- 收集的数据包括手术的指示,视觉敏度,视野, fundus摄影,RNFL和光盘厚度的OCT以及并发症.
- 参数测试用于术前和术后的比较.
主要成果:
- 84%的患者经历了ONSF后视力敏度的改善或稳定,50%的患者达到6/6或更好.
- 在视网膜神经纤维层厚度和视野方面观察到改善,最大益处为360天.
- 常见的并发症包括过渡性双眼视 (25%) 和需要进一步转移CSF (17%),在"其他"指示组的病例率更高.
结论:
- 在IIH和CVST中,ONSF有效治疗与 papilledema相关的视力衰竭,特别是当医疗或手术替代方案失败时.
- 该程序表明视觉功能和视觉神经健康的积极趋势.
- 需要仔细考虑ONSF的ICP升高的各种原因,并承认潜在的并发症.
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