| BackgroundThe incidence of PION in clinic is low, it is rarely reported abroad. There are just some individual reports of PION in China, but they are not systematic and lack of enough clinical samples. So far, we haven’t known very clearly about its clinical manifestation, feature, basis, standard and treatment which is still during exploration. This situation results in omission diagnose easily. The biggest harm of PION is that optic nerve is damaged irreversibly by ischemia, however the fundus abnormity can not be examined by early clinical specialized test obviously. Just because of this, misdiagnosis which happens frequently in the early stage, delays the treatment and then causes neuratrophy. So, the key point is that determining diagnosis and treatment for PION correctly as soon as possible, eliminating edema of the optic nerve quickly and will improving the blood circulation in the optic nerve.ObjectiveBy retrospectively analyzing and studying the characteristics of 25 cases of PION, who came to the third affiliated hospital of Xinxiang medical college from May 2013 to January 2015 for treatment, My study will provide the basis for early clinical diagnosis and active treatment of PION.MethodI analyze retrospectively the history characteristics, clinical manifestations and related inspection data of 25 patients ,who came to the third affiliated hospital of Xinxiang medical college from May 2013 to January 2015 for treating their PION, then study the clinical characteristics, inducing factors and the treatment effect of experimental clinical treatment.Result(1) In the 25 cases of hospitalized patients,12 female cases accounted for 48%, 13 male cases are accounted for 52%, the cases are all the elderly, especially 60 to 80 years old.21 patients with PION have clear etiology of which the major factors are obstructive sleep apnea (OSA), hypertension, diabetes, heart disease.(2) 29 eyes with PION all have different levels of decreased visual acuity and visual field defect. Especially in perspective: With hemianopsia accounted for 24.1%; The fan vision defects (13.8%); Circular vision defects (13.8%); Linked to physiological scotoma segment defect (17.2%); Central scotoma 3 eyes 10.3%; Not typical defect (20.7%).The differences of visual field defect are meaningless in statistics.(3) there are no obvious abnormal by fundus examination of 27 eyes. FFA:4 eyes’ optic disc in the early time is part of a weak fluorescence, filled with slow, uneven, low fluorescence, even lack of filling and the other part is normal fluorescence; 6 eyes’imaging in the late part of the optic disc for compensatory expansion surface capillary leakage pres-ent strong fluorescence are. OCT is 6 eyes appear different degree of optic atrophy.(4) In this group, the prognosis of 29 eyes treatment is good, the vision and the field of vision both have been improved significantly.48.27% of the patients recovered; 48.27% of patients were markedly improved,28.58% of patients turn better. Compared before with after, it’s found that vision has significantly increased after treatment, so there is statistical significance. Compared the different effect when the patients take treatment after the attack, it’s found that the cure rate within 30 days is higher. There is statistical significance.ConclusionThere are many factors which affected PION clinically, inducing obstructive sleep apnea syndrome, hypertension, diabetes, heart disease, etc. The feature of PION is not very typical, which results in clinical misdiagnosis extremely easily, but the visual acuity, ARPD, the VEP, ERG, OCT and FFA all show different conditions of performance, we can definite clinical diagnosis analysis of the PION after thinking overall. Through the experimental treatment, I find the comprehensive treatment by reducing intraocular pressure and taking some drugs which remove blood and stasis, can improve vision of PION patients clinically and partly restore the vision field, so as to obtain the good curative effect. Early diagnosis and treatment can improve the treatment effect,the cure rate and the prognosis. |
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