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W. Shi; Clinical Analysis on the 152 Cases of Traumatic Orbital Apex Syndrome. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4883.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the clinical characteristics and the visual prognosis of traumatic orbital apex syndrome .
The clinical data of the 152 patients were retrospectively analyzed. They were treated at the department of ophthalmology and neurosurgery in Beijing Tongren Hospital between April 2002 and October 2008 . All patients were followed up for 6 months or longer.Combined treatment group was treated with surgery, Methylpredn- isolone impact and neurotrophic drug; drug treatment group had taken the hormone or neurotrophic neurotrophic drug treatment. For the purpose of evaluation , the postoperative outcome of visual acuity was classified into five grades : No light perception,light perception ,hand motion ,finger counter and acuity chart .The visual acuity improvement reaching 1 grade or more was defined as effective and less than 1 grade as inefficient . And to evaluate the improvement of nerve injuries in superior orbital fissure superior orbital fissure of nerve recovery, patients with recover of 2 or more nerves was defined as effective.
Most patients were young, average age was 33.87 ± 1.78 years old.There were 132 cases of male patients and accounted for 86.84% of total cases. The top cause was the traffic accident injuries (65.79%);104 cases had the clear injured focus, of which the amount of temporal face were 52 cases (50%). 118 patients with no light perception (77.63%)before treatment, while after treatment 45 cases (29.61%) improved their visual acuity, in which no light perception to light only six cases (5.08%). The effective vision improvement between the integrated treatment group and the drug treatment group was significantly different(P<0.05), 36 cases were improved in the integrated treatment group(50.70%), while in the drug treatment group there were only 9 cases(11.11%). 112 cases (73.68%) had the effective nerve restoration of the Superior orbital fissure after treatment, in which 64 cases were of the integrated treatment group (90.14%)and 48 cases were of the drug treatment group (59.26%), the differences were statistically significant (P<0.05).
The improvement of visual acuity in patients with light perception was better than those with no light perception; ptosis was improved first among the oculomotor restoration, but it does not suggest the good visual prognosis; Early and combined treatment may led to the better visual prognosis.
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