Abstract:

Objective　To observe the clinical efficacy of vinblastine sustained-release capsules combined with brimonidine tartrate eye drops in the treatment of anterior ischemic optic neuropathy. Methods　A prospective study was conducted on 118 patients with anterior ischemic optic neuropathy admitted to Jining Puming Eye Hospital and Jinan Second People's Hospital from March 2020 to March 2022. They were randomly divided into a conventional group (59 cases with 64 eyes) and a combined group (59 cases with 64 eyes) by the red blue bicolor method. The routine group [31 men (35 eyes) and 28 women (29 eyes); 51-60 (55.78±4.20) years old; disease course 5-10 (7.28±2.11) days] were treated with brimonidine tartrate eye drops, and the combined group [30 men (34 eyes) and 29 women (30 eyes); 51-61 (55.82±4.31) years old; disease course 5-10 (7.30±2.15) days] with vinblastine sustained-release capsules and brimonidine tartrate eye drops. The clinical efficacies and incidences of adverse reactions of the two groups were compared. t and χ² tests were applied. Results　The total effective rate of the combined group was higher than that in the conventional group [96.88% (62/64) vs. 79.69% (51/64)], with a statistical difference (χ²=9.14, P<0.05). After the treatment, the thicknesses of peripheral nerve fiber layer and retinal ganglion cell complex in the combined group were lower than those in the conventional group [(66.15±11.19) μm vs. (83.06±14.23)μm and (61.37±6.27) μm vs. (74.11±7.82) μm], with statistical differences (t=7.473 and 10.17, both P<0.05). After the treatment, the 60'P100 and 15'P100 latencies in the combined group were lower than those in the conventional group [(108.21±2.34) ms vs. (110.78±2.74) ms and (110.25±3.12) ms vs. (113.58±3.68) ms], with statistical differences (t=5.71 and 5.52, both P<0.05). After the treatment, the amplitudes of 60'P100 and 15'P100 waves in the combined group were higher than those in the conventional group [(5.21±1.07)μV vs. (4.23±1.02) μV and (6.79±1.26) μV vs. (5.38±1.14) μV], with statistical differences (t=4.82 and 6.64, both P<0.05). After the treatment, the standard deviation of corrected visual field shape and the mean deviation of visual field in the combined group were significantly lower than those in the conventional group [(3.34±0.38) vs. (3.72±0.42) and (-5.01±1.42) vs. (-6.54±1.59)], with statistical differences (t=5.37 and 5.74, P<0.05). After the treatment, the light sensitivity and visual acuity of the combined group were significantly higher than those of the conventional group [(17.51±2.30) dB vs. (14.52±2.27) dB and (0.73±0.25) vs. (0.48±0.16)], with statistical differences (t=7.40 and 6.74, P<0.05). Conclusion　Vinblastine sustained-release capsules combined with brimonidine tartrate eye drops has obvious effect in the treatment of patients with anterior ischemic optic neuropathy, and can significantly improve their visual field, visual acuity, light sensitivity, and amplitude and latency of P100 wave of visual evoked potential and reduce the thickness of peripheral nerve fiber layer and retinal ganglion cell complex, with high safety.

Key words:

Anterior ischemic optic neuropathy, Vinblastine sustained-release capsules, Brimonidine tartrate eye drops, Light sensitivity

摘要：

目的　观察长春胺缓释胶囊联合阿法舒眼液治疗前部缺血性视神经病变患者的临床疗效。方法　选取济宁普明眼科医院和济南市第二人民医院在2020年3月至2022年3月期间收治的118例前部缺血性视神经病变患者进行前瞻性研究，通过红蓝双色球法随机分为常规组（59例，64眼）和联合组（59例，64眼）。常规组男31例（35眼）、女28例（29眼），年龄51～60（55.78±4.20）岁，病程5～10（7.28±2.11）d，应用阿法舒眼液治疗；联合组男30例（34眼）、女29例（30眼），年龄51～61（55.82±4.31）岁，病程5～10（7.30±2.15）d，在常规组基础上口服长春胺缓释胶囊治疗。比较两组临床疗效和不良反应发生情况。统计学方法采用t检验与χ²检验。结果　与常规组相比，联合组总有效率更高［96.88%（62/64）比79.69%（51/64）］，差异有统计学意义（χ²=9.14，P<0.05）。治疗后，联合组的盘周神经纤维层和视网膜神经节细胞复合体厚度均低于常规组［（66.15±11.19）μm比（83.06±14.23）μm、（61.37±6.27）μm比（74.11±7.82）μm］，差异均有统计学意义（t=7.47、10.17，均P<0.05）。治疗后，联合组的60'P100 波潜时、15'P100 波潜时均低于常规组［（108.21±2.34）ms比（110.78±2.74）ms、（110.25±3.12）ms比（113.58±3.68）ms］，差异均有统计学意义（t=5.71、5.52，均P<0.05）；治疗后，联合组的60'P100 波振幅、15'P100 波振幅高于常规组［（5.21±1.07）μV比（4.23±1.02）μV、（6.79±1.26）μV比（5.38±1.14）μV］，差异均有统计学意义（t=4.82、6.64，均P<0.05）。治疗后，联合组的视野校正形态标准差、视野平均偏差均低于常规组［（3.34±0.38）比（3.72±0.42）、（-5.01±1.42）比（-6.54±1.59）］，差异均有统计学意义（t=5.37、5.74，均P<0.05）；治疗后，联合组的光敏感度、视力水平均高于常规组［（17.51±2.30）dB比（14.52±2.27）dB、（0.73±0.25）比（0.48±0.16）］，差异均有统计学意义（t=7.40、6.74，均P<0.05）。结论　长春胺缓释胶囊联合阿法舒眼液治疗前部缺血性视神经病变患者效果明显，能显著改善患者视野水平、视力水平、光敏感度和视觉诱发电位P100波振幅及潜时，降低盘周神经纤维层和视网膜神经节细胞复合体厚度，且安全性较高。

关键词:

前部缺血性视神经病变, 长春胺缓释胶囊, 阿法舒眼液, 光敏感度