Clinical Retrospective Analysis Of 49 Cases Of Optic Neuritis

Objective: Research the cause and clinical characteristics of patients of optic neuritis in the first hospital ophthalmology of Jilin University, and find out the most significant therapy through comparing the effect of different methods of therapy.Subjects and Methods: Retrospectively analyze 49 cases and 71 eyes of diagnosed patients with optic neuritis, who visit the first hospital ophthalmology of Jilin University from January 2005 to December 2010, containing 30 cases of intraocular optic neuritis and 19 cases of retrobulbar optic neuritis, 22 cases in both eyes and 27 cases of monocular, 22 male and 27 female, aged 4~71 years old, at the average of 35.1. Give patients routine eye examinations, physical examinations and different treatment methods. Treatment group a intravenous methylprednisolone combined with prednisone for oral use. Treatment group b intravenous dexamethasone combined with prednisone for oral use. Treatment group c takes orally prednisone. Control group did not give glucocorticoid. All four treatment group combine with adjuvant therapy such as retrobulbar injection of dexamethasone and giving vasodilator, energy mixture, vitamin and Chinese drug. If patients have exact causes, which contain such as bacterial infection, virus infection and so on, give appropriate treatment. Use X2 test for statistical analysis and approach the cause, visual acuity, ophthalmalgia, pupil, eyeground, visual field, visual evoked potential and effect of different therapy.Result: There are several causes of disease such as 3 cases of upper respiratory tract infection, 2 cases of sinusitis, 2 cases of devic disease, 1 case of multiple sclerosis, 1 case of syphilis, 1 case of gingivitis, 1 case of pneumonia, 1 case of encephalomyelitis, 1 case of orbital cellulitis and 36 cases of no exact cause. When patients are admitted to hospital, their corrected visual acuity was worse than 0.1 in 36 eyes, varied from 0.1 to 0.5 in 22 eyes, and 0.5 or better in 13 eyes. 24 cases have ophthalmalgia and 25 cases have no ophthalmalgia. 31 cases have pupil movement disorder, when 18 cases have no pupil movement disorder. 30 cases have various abnormal eyegrounds when 19 cases have normal ones. 45 cases appeared various abnormal manifestation of visual field, but 4 cases did not examine. 29 cases happened elongation of latent period or (and) decrease of amplitude in VEP, but 8 cases are normal and 12 cases did not examine. 1 case happened white matter demyelination in head MRI, but 21 cases have no abnormal and 27 cases did not examine. Given flushing dose of glucocorticoid for total body, local hemisphere after injection, vasodilating agent, energy mixture, vitamin B and Chinese drug, effective power of treatment group a is 96.2%, treatment group b is 60.0%, treatment group c is 88.9%. The effective power of control group is 76.9%.Conclusion: The incidence of intraocular optic neuritis is obviously higher than the retrobulbar optic neuritis in the first hospital of Jilin University for near 6 years, mostly aged from 15~55 years old, at the average of 35.1. There are various cause of disease, but mostly did not have exact one. Parts of cause are acute or chronic infections and small parts are multiple sclerosis and devic disease. When patients were admitted to hospital, corrected visual acuity was worse than 0.1 in 50.7% patients. Changes of visual field are various, especially common with central and paracentral scotoma. The above results are apparently different from the western country, but close to the Japan which is belong to eastern country. So race difference of eastern and western country should not be ignored. Firstly emphasis on finding out the cause and early giving the treatment, but do not have effective treatment now, because of complicated causes. We still use the result of study of ONTT. The result is giving stosstherapy of methylprednisolone and oral administration of glucocorticoid combine with giving vasodilating agent, energy mixture and vitamin. If needed, we also give antibiotics or antiviral agents. Our results of study further certify the significance of curative effect.