ISSN 1673-3770 CN 37-1437/R
Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (4): 56-59.doi: 10.6040/j.issn.1673-3770.1.2020.051
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To explore the best method for diagnosis and treatments of post-surgical posterior ischemic optic neuropathy(PION). MethodsReview the medical records of a 78-year-old female patient who presented with sudden vision loss in her right eye on the fourth day after phacoemulsification and implantation of a posterior chamber intraocular lens in other hospital. After the electrophysiological examination and fundus fluorescein angiography, the patient was diagnosed as posterior ischemic optic neuropathy after cataract surgery in his right eye. She was administered with a retrobulbar injection of Anisodamine and placed on steroid pulse therapy. ResultsOn the 19th day after treatment, her visual acuity had recovered to 0.05. ConclusionThis is a rare case, and since post-surgical posterior ischemic optic neuropathy(PION)has no definite and effective treatment yet, active vigilance should be maintained before surgery. Detailed systemic history and physical examination are important for patients with high risks of developing PION, especially for evaluating their systemic hemodynamics. To sum up, PION should be considered in patients who have sudden severe vision loss and/or visual field defects with no obvious changes in the fundus after excluding other optic nerve diseases.
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| [1] | This study was conducted to explore the preoperative risk factors for postoperative adhesion in patients with chronic rhinosinusitis(CRS)undergoing functional endoscopic sinus surgery(FESS), and to construct a risk score model to evaluate their predictive effect. MethodsA retrospective study was conducted on 323 patients with CRS who underwent FESS at our hospital between January 2015 and June 2018. The risk factors for postoperative adhesion were screened using a multivariate logistic regression analysis. The risk score was assigned according to the odds ratio(OR)value, and a receiver operating characteristic(ROC)curve was drawn to evaluate the predictive effect. ResultsPostoperative adhesion occurred in 35 patients(10.8%). The logistic regression results showed that concha bullosa, primary FESS, operative experience less than 10 years, and a history of middle turbinate resection were independent risk factors for postoperative adhesion in FESS. The OR values were 1.12(95% CI: 1.06-1.18), 3.87(95% CI: 2.23-5.51), 3.19(95% CI: 2.07-4.31), and 2.24(95% CI:1.95-2.53), respectively. The risk score model assigned 1 point for vesicular middle turbinate, 4 points for first time FESS, 3 points for operative experience less than 10 years, and 2 points for middle turbinate resection. The ROC curve analysis showed that the area under the curve(AUC)was 0.784(95% CI: 0.672-0.896, P<0.05). When 4 points were selected as the cut-off point, the Jordan index was the largest, with a sensitivity of 75.1% and a specificity of 73.6%. ConclusionThe incidence of postoperative adhesion in 323 patients with CRS who underwent FESS was 10.8%. The risk score model has certain reference value for predicting high-risk postoperative adhesion.. Potential risk factors and evaluation of a predictive risk score model for postoperative adhesion in functional endoscopic sinus surgeryCHEN Dong1, YU Hong2, LI Yang1, HUANG Qiang1, FANG Min1 1. Department of Otolaryngology, Jiangyou Peoples Hospital, Jiangyou 621700, Sichuan, China; 2. Department of Pathology, Jiangyou Peoples Hospital, Jiangyou 621700, Sichuan, ChinaAbstract:Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 87-91. |
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