牙源性视神经病变,临床,治疗动态:1例报告

Moyseyenko Nm
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摘要

视神经病变由于牙病变是罕见的,但引起复杂的持续功能障碍,是难以诊断。本病例报告的目的是通过治疗策略和观察视神经的结构动力学和功能变化,并结合一个临床病例来显示牙源性视神经病变。根据乌克兰伊万诺-弗兰科夫斯克国立大学眼科对患者进行会诊。进行了计算机视野检查、视神经光学相干断层扫描(OCT)、脑磁共振成像(MRI)、鼻窦计算机断层扫描(CT)和免疫血液检查等检查。患者知情同意访问个人数据并将其用于科学目的。在患者S.的病例中,神经炎合并血管束前部病变归因于上颌窦内多发龋和牙齿脱垂的背景。治疗方法包括牙医治疗龋齿和皮质类固醇脉冲疗法。从结果来看,右眼和左眼的神经纤维肿胀分别减少了35%和19%。右眼的平均敏感度阈值提高了79%,左眼提高了90%。总之,我们确认牙源性视神经病变是一种罕见的视神经损伤形式。两阶段治疗(牙科和皮质类固醇)减少神经纤维肿胀,增加视网膜神经节细胞的敏感性。
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Odontogenic Optic Neuropathy, Clinic, Treatment Dynamics: A Case Report
Optic nerve neuropathy due to dental lesions is rare but causes complex persistent functional disorders that are difficult to diagnose. The aim of this case report is to show odontogenic optic neuropathy through treatment tactics and observation of structural dynamics and functional changes of the optic nerve with the help of a clinical case. The consultation of the patient was done as per the Department of Ophthalmology, Ivano-Frankivsk National University, Ukraine. Tests such as computed perimetry, Optically Coherent Tomography (OCT) of the optic nerve, Magnetic Resonance Imaging (MRI) of the brain, Computed Tomography (CT) of the paranasal sinuses and immunological blood tests were performed. The patient gave informed consent to access personal data and use it for scientific purposes. In the case of patient S., the combination of neuritis with lesions of the anterior part of the vascular tract is attributed to the background of multiple caries and prolapse of the teeth of the upper jaw in the sinus. Treatment includes a regimen by a dentist for caries and pulse therapy with corticosteroids. From the result, it was possible to reduce the swelling in the nerve fibers of the right eye by 35% and the left eye by 19%. The average sensitivity threshold in the right eye increased by 79% and in the left eye by 90%. In conclusion, we confirm that odontogenic optic neuropathy is a rare form of optic nerve damage. Two-stage treatment (dental and corticosteroids) reduces the nerve fibers swelling and increases retinal ganglion cells sensitivity.
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