| Part one of Clinical Research The application of the OCT in the different disease course of anterior ischemic optic neuropathyObjective:To investigate the relationship between retinal nerve fiber layer(RNFL)thickness of the anterior ischemic optic neuropathy and the development course of the disease.Methods:This study adopted the method of retrospective clinical study.The object of study was 45 cases of patients(54 eyes)forming the experimental group who were identified as AION in the outpatient clinic and ward of the hospital from March 1,2011 to February 1,2015.All the patients of the experimental group must be measured by application of optical coherence tomography(OCT)instrument and we should record the RNFL thickness of the four quadrants around the disc.At the same time,31 cases of healthy volunteers(62 eyes)in the healthy group were examined by OCT to get the RNFL thickness of the four quadrants around the disc.Results:There are 45 cases of patients(54 eyes)with anterior ischemic optic n europathy.The average age was 58.41 ± 10.33 years old.Among them,35 patients we re found with systemic diseases while 10 cases of patients were with no systemic dise ases.The average RNFL thickness increased duringl-10 days after the onset of AION;and it rose to the top in 11-20 days;In the stage of 21-30 days and 31-40 days,i t began to decline,while the edema subsided at the same time;during 41-90 days,the average RNFL thickness started to become thin;during 91-365 days,the RNFL thick ness became thin significantly;after 365 days,the condition of becoming thin tended to be stable.The study also showed that edema in the lower quadrant was the most s erious of the four quadrants,and the nasal side as well as the temporal quadrant were first damaged.Conclusions:Using OCT to measure RNFL thickness can monitor the edema of AION in the disease development course.Part Two of Clinical Research The clinical research based on the technology of magnetic resonance diffusion tensor imaging for the treatment of anterior ischemic optic neuropathy with flavored astragalus membranaceus soupObjective:to evaluate the clinical curative effect of flavored astragalus membranaceus soup in the treatment of anterior ischemic optic neuropathy(AION)and study variation characteristics of magnetic resonance diffusion tensor imaging(DTI)in the treatment of anterior ischemic optic neuropathy with flavored astragalus membranaceus soup.Methods::37 cases of patients with anterior ischemic optic neuropathy(AION)between January,2015 and January,2017 from the ophthalmology outpatient and ward were collected for the experimental group,while 35 cases of healthy volunteers were selected for the health group.All the people of the experimental group and the health group were checked with DTI,visual acuity,visual inspection,OCT and VEP,and all the datas of the examinations were recorded.In accordance with the principle of voluntary,24 cases of patients(32 eyes)from the experimental group voluntarily accepted the treatment of the flavored astragalus membranaceus soup,forming the treatment group.The patients of the treatment group within 7 days before the treatment were checked with DTI,visual acuity,visual inspection,OCT and VEP.And then the patients were treated with flavored astragalus membranaceus soup for one month.After the treatment,all the patients were checked with DTI,visual acuity,visual inspection,OCT and VEP.All the materials for the treatment group were recorded at the same time.Results:(1)The analysis results of comparison before and after treatment in the treatment group:there were significant differences in best corrected visual acuity?value of MS and MD of vision field?P100 wave latent parameters and N75-P100 amplitude before and after treatment while there was no statistically significant difference between RNFL thickness before and after treatment.After treatment,the condition of best corrected visual acuity increases;the MS value of the view field was raised and the MD value decreased;the P100 wave latent delay decreased and the N75-P100 amplitude increased.(2)the results of the DTI parameters:?the results of the DTI parameters of the health group:the health group included 35 cases(67 eyes)of people.The average value of FA?MD?RA??"??? was respectively 0.468±0.150,1.105±0.403,0.165±0.172,1.402±0.542,0.972±0.360.?the analysis and results of DTI parameters comparison between the sick eyes and the healthy eyes in the experimental group:there were 34 cases of AION patients with 41 sick eyes and 17 healthy eyes.The difference of FA values between healthy eyes and sick eyes was statistically significant.The average values(0.214)of FA in the sick eyes were lower than those in the healthy eyes(0.437).Except the FA value,there were no statistically significant difference between the values of MD?RA??"???.)The analysis and results of DTI parameters comparison between the experimental group and the health group:there were 34 cases of AION patients(41 eyes))from the experimental group while there were 35 case of healthy people(67 eyes)from the health group.The differences of FA?MD?RA between the experimental group and the treatment group were statistically significant.Compared with the health group,FA value and RA value of experimental group dropped,and the MD value increased.There were no statistically significant difference between the values of ?"???.?The analysis and results of DTI parameters comparison in the treatment group before and after treatment:the treatment group included 16 cases(22 eyes)of AION patients.The differences of FA?MD??? was statistically significant.After treatment,FA value dropped,and the MD value and the ?? value increased.There were no statistically significant difference between the values of ?" and RA.(3)The linear correlation research results between DTI parameters of the optic nerve and the parameters of ophthalmology:?The correlation analysis results between the parameters of DTI of the optic nerve and MD and MS value of field of vision:the value of FA,RA are weakly correlated to the MD value(rs = 0.336,p = 0.032;rs=0.358,p = 0.021).? The correlation analysis results between the parameters of eye optic DTI and OCT RNFL thickness:the value of FA are positively correlated to RNFL thickness(rs = 0.694,p = 0.011).?The correlation analysis results between the parameters of DTI of the optic nerve and Vep:the value of FA are negatively correlated to P100 wave snorkeling(rs=-0.731,p=0.000).And the value of FA and RA are positively correlated to N75-P100 amplitude.(rs=0.576,p=0.002;rs=0.497,p=0.008).Conclusion:(1)Treating anterior ischemic optic neuropathy with flavored astragalus membranaceus soup can effectively improve visual acuity and visual sensitivity,lower visual field defect rate,reduce the delay level of the P100 wave snorkeling and improve visual evoked potential N75-P100 amplitude,so as to improve the quality of visual function.(2)For the AION patients after treatment with flavored astragalus membranaceus soup in the treatment group,FA value decreases,the MD value and the ?? value rise.(3)The linear correlation results between DTI parameters of the optic nerve and the parameters of ophthalmology:the value of FA is correlated to the MD value of visual field,RNFL thickness,P100 wave snorkeling and N75-P100 amplitude.And RA is correlated to the MD value of visual field and N75-P100 amplitude. |
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