| Background:In countries and regions where had been reported on optic neuritis epidemiology, the incidence of optic neuritis was influenced by race, gender, age, geography, occupation, etc. However, the race, lifestyle and geographical environment in China were different from the other countries, especially the United States and Europe. European and American countries currently had a relatively complete system of registration of cases, and there were a large number of reports on optic neuritis epidemiology. At the same time, as the cross discipline of Neurology and Ophthalmology--neuro-ophthalmology, multiple sclerosis and neuromyelitis optica also had relevant epidemiological studies in this countries. So far, there was not report on optic neuritis epidemio logical investigations of national multi-center, large-scale in our country. Therefore, the epidemiology and etiology of optic neuritis in our country was still a lack of unified understanding. However, optic neuritis was the most common clinical disease which could cause blindness during young patients in the Department of ophthalmology; China had nearly1.4billion populations, whether the incidence or prevalence could not be ignored, so we expected trans-regional, multi-center cooperation to provide the basis for prevention and treatment of optic neuritis.Literature ReviewThe two parts mainly includes:"Research progress of optic neuritis epidemiology" and "Origin of TCM name on optic neuritis and understanding on optic neuritis of famous veteran doctors". The former review:through the review of the related literature at home and abroad in recent years, the article summarized the etiology and epidemio logical characteristics of optic neuritis. It is expected to provide reference and comparison for the epidemio logical investigation of cross regional, multi-center cooperation. The latter review: through the review of ancient and modern literature, the article summarized the origin of TCM name on optic neuritis and understanding on optic neuritis of famous veteran doctors.Clinical ResearchObjective:Firstly, according to the "optic neuritis epidemiological studies ", we obtained epidemiological data (2010.11.1-2013.10.31) on optic neuritis of department of Ophthalmology, Dongfang Hospital in Beijing University of TCM, including the clinical data of the incidence of optic neuritis, social-demographic characteristics, diagnosis, family history, medical history, laboratory tests, treatment and the case after three months, etc. We described the clinical features of optic neuritis classification and outcome, in order to provide useful clues for further elucidate the etiology and pathogenesis of the disease; Secondly, to research of symptomatology as the center, we collect the syndromatology of TCM during the periods by using a design method of clinical epidemiology, in order to provide an objective basis for syndrome diagnosis on sudden blindness, syndrome differentiation type and the relationship between age, gender and type of syndrome.Methods:Choosing outpatient, emergency and inpatient of department of Ophthalmology, Dongfang Hospital in Beijing University of TCM from November1,2010to October31,2013. The source objects of study included review and monitor of cases:(1) review of cases: during the period from November1,2010to October31,2012(duration of2years), we extracted information of the patients who were diagnosed with optic neuritis in hospital record room;(2) monitor of cases:during the period from November1,2012to October31,2013(duration of1years), patients with acute visual loss or other symptoms and diseases coming to see doctor by diagnosing with optic neuritis, optic neuritis relapse as well as MS and NMO correlation optic neuritis outpatient, emergency and inpatient. This research mainly used the questionnaire survey method to collect patient information. Divided in two ways:the review cases were recorded; the new recruitment of patients, by means of case copy and questionnaires. Used the EpiData3.1data software, established the REC database, and then used the SPSS18software for statistical analysis of the data, and calculated the disease frequency and descriptive study and analytical study.Results:(1) The incidence of optic neuritis in department of Ophthalmology, Dongfang Hospital in Beijing University of TCM was65.6/10;(2) social-demographic characteristics: in the gender composition, the incidence of optic neuritis on female was higher than on male, male to female ratio was1:1.32; in the age distribution, the average age of optic neuritis patients was30.09±12.97years, mainly to young; in the cultural level, cultural level of patients with optic neuritis was higher; in the occupation distribution, students with optic neuritis were the highest incidence, and the incidence of mental workers was higher than the rate of labor; at the same time, there was no correlation between nationality, residence and the incidence of optic neuritis.(3) optic neuritis type:there was the highest proportion in patients with idiopathic optic neuritis;(4) present history: there was higher proportion in winter and spring season in patients with neuritis optic neuritis patients; the proportion of patients with two eyes of optic neuritis was38.5%; it was higher proportion in patients with emotional stress, upper respiratory tract infection and fatigue; optic neuritis patients suffering from visual acuity<0.1accounted for52.3%; all optic neuritis patients with VEP examination were abnormal; there were higher proportion in optic neuritis patients with abnormal vision in "central scotoma"" diffuse loss"" concentric visual field ";50.5%of optic neuritis patients were newly diagnosed, and recurrence accounted for47.7%;(5) the recovery of visual acuity after three months:the comprehensive treatment cure rate was 20.5%, and the total effective rate was68.7%;(6) The characteristics of TCM syndrome type distribution of eye system sudden visual loss:5kinds of syndrome type distribution in order:deficiency syndrome of both liver and kidney yin (34cases,31.2%)> liver depression and Qi stagnation (32cases,29.4%)> deficiency of both Qi and blood (25cases,22.9%)> hyperactivity of fire due to yin deficiency (lOcases,9.2%)> excess heat syndrome of the liver (8cases,7.3%); In the correlation analysis of gender and type of syndrome, there were statistically significant differences in the various syndromes constitute of male and female patients; In the correlation analysis of age and type of syndrome, there was not a statistically significant difference among different ages of patients with optic neuritis in the distribution of syndrome.Conclusion:In the outpatient department of Ophthalmology Dongfang Hospital of Beijing University of TCM:(1)It was relatively higher in optic neuritis patients;(2) The incidence of optic neuritis is relatively high in young women with higher cultural level, and the incidence of mental workers was higher than manual workers, winter and spring season were the peak period of incidence;(3) Most of the optic neuritis patients had prodromal history, higher incidence on both eyes, poor vision, different degrees of abnormal VEP and visual field;(4) The cure rate and total effective rate were lower after three months of treatment;(5) The characteristics of TCM syndrome type distribution of eye system sudden visual loss: Horizontal comparison, male patients with deficiency syndrome of both liver and kidney yin and liver depression and Qi stagnation were more common, while female patients with deficiency syndrome of both liver and kidney yin, liver depression and Qi stagnation and deficiency of both Qi and blood are more common; Longitudinal comparison, the proportion of female patients was higher than male patients among deficiency syndrome of both liver and kidney yin, liver depression and Qi stagnation and deficiency of both Qi and blood, the proportion of male patients was higher than female patients between excess heat syndrome of the liver and hyperactivity of fire due to yin deficiency; Comparison with deficiency syndrome of both liver and kidney yin, liver depression and Qi stagnation and deficiency of both Qi and blood in female patients is relatively concentrated, while male patients with five kinds of syndromes constitute relatively dispersed; There was no statistically significant difference among different ages of patients with optic neuritis in the distribution of syndrome. |
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