| Clinical study ?:Changes of ocular hemodynamics in NA-AION and its correlation with RNFL thicknessObjective:Explore the changes in hemodynamics in the eye of NA-AION and its correlation with RNFL thickness.Methods:This study used a retrospective clinical study approach.The study subjects were patients with non-arteritic anterior ischemic optic neuropathy who were admitted to the ward of the Oriental Hospital of Beijing University of Chinese Medicine from January 2018 to December 2018.The control group selected color Doppler ultrasonography(CDFI)examination of the ocular blood vessels in the color Doppler ultrasound room from January 2018 to December 2018,and the age matched with the NA-AION group.All patients underwent CDFI examination of the ocular blood vessels.measuring the systolic peak blood flow velocity(PSV)and resistance index(RI)of the posterior ciliary artery(sPCA),central retinal artery(CRA),and the ophthalmic artery(OA).Tube diameter,PSV and RI,and OCT were used to examine the thickness of the retinal nerve fiber layer(RNFL).Statistical analysis was performed on the data using SPSS 20.0 software.Results:A total of 19 patients with NA-AION were enrolled in the study,including 8 males and 11 females,aged 46-71 years(mean age 57.53±8.04 years);7 patients with monocular onset,12 patients with bilateral onset,total 31 eyes.The time of onset was as short as 1 day and the longest was 10 years.The interval between eyes was 1 week and the longest was 6 years.(1)Hemodynamic contrast between the affected group and the control group:The central retinal artery and ophthalmic artery RI of the affected group were significantly higher than those of the control group(P<0.01);the eye artery diameter of the affected group was significantly higher than that of the control group(P<0.01),but the PSV of the short ciliary artery,the central retinal artery,and the ophthalmic artery were not significantly different from the control group;(2)Contrast between the affected side and the healthy side of the NA-AION patient:There was no significant difference in the blood flow velocity and resistance index between the affected side and the healthy side in the short ciliary artery,the central retinal artery,and the ophthalmic artery;(3)Correlation between CDFI indexes of ocular blood vessels and RNFL thickness in patients with NA-AION:PSV of ophthalmic artery was negatively correlated with thickness of nasal RNFL(P<0.05).correlation coefficient was-0.425.The other parameters of blood flow were not significantly correlated with the thickness of RNFL;(4)Correlation between CDFI indexes of ocular blood vessels and RNFL thickness in non-acute patients with NA-AION:There was a negative correlation between the diameter of the ophthalmic artery and the thickness of the nasal RNFL(P<0.05),and the correlation coefficient was-0.446.The ophthalmic artery PSV was negatively correlated with nasal RNFL thickness(P<0.01).and the correlation coefficient was-0.581.The other parameters of blood flow were not significantly correlated with RNFL thickness.Conclusion:1.The vascular resistance index of patients with NA-AION increased,but the blood flow velocity did not change significantly.2.The ocular flow velocity of NA-AION patients was negatively correlated with the thickness of nasal RNFL,while the other parameters of blood flow were not significantly correlated with RNFL thicknessClinical study ?:Therapeutic effect of Jiawei Huangqi Decoction on thetreatment of qi deficiency and blood stasis type NA-AIONObjective:To evaluate the efficacy of Jiawei Huangqi Decoction in the treatment of non-arteritic anterior ischemic optic neuropathy(NA-AION).Methods:This study used a retrospective clinical study.The study subjects were patients with non-arteritic anterior ischemic optic neuropathy who were admitted to the ward of the Oriental Hospital of Beijing University of Chinese Medicine from January 2017 to December 2018,and the syndrome differentiation of TCM was qi deficiency and blood stasis.All patients were treated with Jiawei Huangqi Decoction plus conventional therapy(improving circulation+nutritional nerve).The best corrected visual acuity(BCVA)and visual field were detected before and after treatment.Visual acuity and visual field score were respectively performed.,valid and invalid three categories for evaluation.Statistical analysis was performed on the data using SPSS 20.0 software.Results:A total of 24 patients with qi deficiency and blood stasis type NA-AION were enrolled in the study,including 7 males and 17 females,aged from 33 to 71 years(mean age 55.46±8.11 years);14 patients with monocular onset,10 patients with both eyes,a total of 34 eyes.The time of onset was as short as 1 day and the longest was 10 years.The interval between eyes was 1 month and the longest was 7 years.(1)Best corrected visual acuity:from 0.47±0.36 before treatment to 0.56±0.38 after treatment.the difference was statistically significant(P<0.01);(2)Visual field:The mean sensitivity(MS)increased from 12.34±6.62 before treatment to 15.03±6.42 after treatment,and the mean defect(MD)decreased from 13.39± 1.26 before treatment to 10.52± 1.14 after treatment,and the difference were statistically significant(P<0.01);(3)Comprehensive efficacy:3 patients were significantly effective after treatment,13 were effective,8 were ineffective,and the total effective rate was 67%;(4)The relationship between efficacy and gender:the total effective rate of males was 63.6%,and the total female effective rate was 56.5%,the difference was not statistically significant(P>0.05);(5)The relationship between curative effect and age:the total effective rate is 50%for patients aged 50 years and younger,66.7%for patients aged 51-60 years,and 50%for patients aged 61 years and older.The difference between the three is not statistically significant(P>0.05);(6)The relationship between curative effect and basic visual acuity:The total effective rate of patients with basic visual acuity between 0.1 and 0.5 was 86.7%,which was the best group in the three groups,followed by the basic visual acuity<0.1 group of which the total effective rate was 50%,and the basic visual acuity>0.5 group was the worst,and the total effective rate was 30.8%.Among them,the patients with basic visual acuity between 0.1 and 0.5 were significantly better than those with basic visual acuity>0.5(P<0.01);(7)The relationship between curative effect and disease course:the total effective rate of patients within 1 month of onset is 64.3%?the total effective rate of patients with onset of 1 month to 1 year is 45.5%,and the total effective rate of patients with onset of more than 1 year is 66.7%,the difference between the three was not statistically significant(P>0.05).Conclusion:1.Jiawei Huangqi Decoction combined with conventional treatment can effectively improve the vision and visual field of patients with qi deficiency and blood stasis type NA-AION;2.The effect of Jiawei Huangqi Decoction combined with conventional therapy on qi deficiency and blood stasis type NA-AION is related to basic vision.Not related to gender,age,and duration of illness. |
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