Clinical Effects of Ganciclovir Combined with Methylprednisolone in Treating Viral Optic Neuritis_West China Medical Journal

Authors：

LI Yingchun ¹ ,  FAN Yingchuan ² , HU Jianbin ² , CHEN Yuchuan ¹ , LIU Yali ¹ , LI Yu ¹

1. Department of Ophthalmology, No. 4 West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 2. Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial Pepole ’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

FAN Yingchuan, Email: diarychun@yahoo.com.cn

Keywords：

视神经炎; 治疗; 更昔洛韦; 甲泼尼龙

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目的　比较更昔洛韦联合甲泼尼龙综合疗法和甲泼尼龙综合疗法治疗病毒性视神经炎的疗效。方法　将2008年10月－2010年3月入院41例（60只眼）病毒抗体检测阳性的病毒性视神经炎患者随机分为治疗组，21例30只眼）和对照组（20例30只眼）。于治疗前和治疗第3、7、14、30、90、180天观察两组患者的视力、视野。结果　两组患者的视力、平均视野缺损治疗组采用更昔洛韦联合甲泼尼龙综合疗法，对照组采用甲泼尼龙综合疗法。均随时间得到改善（P＜0.001）。两组患者视力在治疗的第3天开始恢复，30 d治疗组视力明显优于对照组（P＜0.05），治疗180 d时两组视力改善无差异（P＞0.05）；治疗组与对照组分别在第7天和第14天平均视野缺损开始恢复（P＜0.001）。结论　更昔洛韦联合甲泼尼龙综合疗法较单纯甲泼尼龙综合疗法治疗病毒性视神经炎能更快提高患者视力、恢复视野、改善患者视觉质量。

Citation： LI Yingchun,FAN Yingchuan,HU Jianbin,CHEN Yuchuan,LIU Yali,LI Yu. Clinical Effects of Ganciclovir Combined with Methylprednisolone in Treating Viral Optic Neuritis. West China Medical Journal, 2012, 27(7): 1054-1056. doi: Copy

1.	BeckRW, Probe JD. What we have 1earned from the optic neuritis treatment trail[J]. Ophthalmology, 1995, 102(10): 1504-1508.
2.	陈贻言.甲泼尼松龙联合施普善治疗急性视神经炎疗效观察[J].国际眼科杂志, 2004, 4(3): 576-577.
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4.	Corssmit EP, Leverstein-van Hall MA, Portegies P, et al. Severe neurological complications in association with Epstein-Barr virus infection[J]. Neurovirol, 1997, 3（6）: 460-464.
5.	蔡莉, 王雨生, 胡丹. 视神经炎98例病因学临床分析[J]. 国际眼科杂志, 2007, 7(3): 734-735.
6.	韦企平, 孙艳红, 宫晓红, 等. 儿童视神经炎83例的病因和预后[J].国际眼科杂志, 2005, 5(1): 123-125.
7.	Roelandt V, Fayol L, Hugonenq C, et al. Retrobulbar optic nerritis and chicken pox: a case report in a child[J]. Arch Pediatr, 2005, 12(3): 278-280.
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10.	de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
11.	Beck RW, Cleary PA, Anderson MM, et al. A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis[J]. N Engl J Med, 1992, 326(9): 581-588.
12.	Nikoskelainen E, Salmi A, Nikoskelainen J, et al. Virus antibody levels in serumandcerebros pinalfluids pecimens from patients with optic neuritis[J]. Acta Neurol Scand, 1977, 63(Suppl): 193-198.
13.	Martin C, Enbom M, Soderstrom M, et al. Absence of seven humanher pesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95(5): 280-283.
14.	蓝育青, 张驰, 夏朝霞, 等. 急性视神经炎的临床特征和疗效分析[J]. 国际眼科杂志, 2008, 8(9): 1935-1937.
15.	Potter NT, Bigazzi PE. Acute optic neuritis associated with immunization with the CNS myelin proteolipid protein[J]. Invest Ophthalmol Vis Sci , 1992, 33: 1717-1722.
16.	严密. 关于视神经炎治疗的新概念[J]. 中华眼底病杂志, 2000, 16(2): 129.
17.	de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
18.	金义翠. 新一代抗病毒药物法昔洛韦[J]. 广州医药, 2002, 33(6): 6.
19.	姜宏, 李保院, 韩业坤, 等. 更昔洛韦的临床应用进展 [J]. 齐鲁药事, 2006, 25(3): 166-168.

1. 　BeckRW, Probe JD. What we have 1earned from the optic neuritis treatment trail[J]. Ophthalmology, 1995, 102(10): 1504-1508.
2. 　陈贻言.甲泼尼松龙联合施普善治疗急性视神经炎疗效观察[J].国际眼科杂志, 2004, 4(3): 576-577.
3. 　Martin C, EnbomM, SoderstromM, et al. Absence of seven human herpesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95（5）: 280-283.
4. 　Corssmit EP, Leverstein-van Hall MA, Portegies P, et al. Severe neurological complications in association with Epstein-Barr virus infection[J]. Neurovirol, 1997, 3（6）: 460-464.
5. 　蔡莉, 王雨生, 胡丹. 视神经炎98例病因学临床分析[J]. 国际眼科杂志, 2007, 7(3): 734-735.
6. 　韦企平, 孙艳红, 宫晓红, 等. 儿童视神经炎83例的病因和预后[J].国际眼科杂志, 2005, 5(1): 123-125.
7. 　Roelandt V, Fayol L, Hugonenq C, et al. Retrobulbar optic nerritis and chicken pox: a case report in a child[J]. Arch Pediatr, 2005, 12(3): 278-280.
8. 　Pless ML. Malik SI. Relapsing-remitting, corticosteroid-sensitive, varicella zoster virus optic neuritis[J]. Pediatric Neurology, 2003， 29(5): 422-424.
9. 　Mechai F, Boutolleau D, Manceron V, et al. Human herpesvirus 6-associated retrobulbar optic neuritis in an HIV-infected patient: response to anti-herpesvirus therapy and long-term outcome[J]. Medical Virol, 2007, 79(7): 931-934.
10. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
11. 　Beck RW, Cleary PA, Anderson MM, et al. A randomized controlled trial of corticosteroids in the treatment of acute optic neuritis[J]. N Engl J Med, 1992, 326(9): 581-588.
12. 　Nikoskelainen E, Salmi A, Nikoskelainen J, et al. Virus antibody levels in serumandcerebros pinalfluids pecimens from patients with optic neuritis[J]. Acta Neurol Scand, 1977, 63(Suppl): 193-198.
13. 　Martin C, Enbom M, Soderstrom M, et al. Absence of seven humanher pesviruses,including HHV-6, by polymerase chain reaction in CSF and blood from patients with multiple sclerosis and optic neuritis[J]. Acta Neurol Scand, 1997, 95(5): 280-283.
14. 　蓝育青, 张驰, 夏朝霞, 等. 急性视神经炎的临床特征和疗效分析[J]. 国际眼科杂志, 2008, 8(9): 1935-1937.
15. 　Potter NT, Bigazzi PE. Acute optic neuritis associated with immunization with the CNS myelin proteolipid protein[J]. Invest Ophthalmol Vis Sci , 1992, 33: 1717-1722.
16. 　严密. 关于视神经炎治疗的新概念[J]. 中华眼底病杂志, 2000, 16(2): 129.
17. 　de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis[J]. JAMA, 2009, 302(9): 985-993.
18. 　金义翠. 新一代抗病毒药物法昔洛韦[J]. 广州医药, 2002, 33(6): 6.
19. 　姜宏, 李保院, 韩业坤, 等. 更昔洛韦的临床应用进展 [J]. 齐鲁药事, 2006, 25(3): 166-168.

West China Medical Journal

Clinical Effects of Ganciclovir Combined with Methylprednisolone in Treating Viral Optic Neuritis

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