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KMID : 0377619610010080823
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Korean Jungang Medical Journal
1961 Volume.1 No. 8 p.823 ~ p.838
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Clinical and laboratory studies on chronic retrobulbar neuritis
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Abstract
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Covering about two-year period, a total of 40 cases of bilateral chronic retrobulbar neuritis were observed. The result, of detail clinical examination, estimation of Vitamin B, and B: contents in serum by means of loading test, pyruvic acid contents in blood and spinal fluid, and liver function tests including serum cholesterol, alkaline phosphatase, , serum protein electrophoresis etc, in laboratory were presented.
The investigation was performed to ascertain whether the nutritional disturbance especially Vitamin B deficiency and correlating liver function disorder affect as a causative to this chronic disease.
1.) The range of age was 14 to 60 in 40 patients. The visual improvement was not prominent in all cases and the vision unchanged or deteriorated; cases during the observation were twenty(50 0) in number.
2) As the one of causative factors, some associated-conditions were disclosed clinically which comprise early multiple sclerosis(2 cases), basal arachnoiditis (3 cases), maxillary sinusitis(3 cases, only according to X-ray pictures), polyneuritis(1 case), lactation(5 cases) and previous severe malnutrition l(1 case).
3) 16 cases of patients had centro-cecal scotoma whereas 18 cases of central scotoma, 5 cases of paracentral scotoma and one case of central scotoma with concentric constriction in visual field.
4) The mean values of the Vita -min B,1 contents in serum showed 1.O6% on total cases with slight deficient condition after the loading test. In addition to that the result of loading test in Group B (the vision unchanged or deteriorated cases) revealed that the tendency of latent or endogeuous deficiency which can be induced as the disturbance of utilization was characteristic. While the riboflavin contents in blood showed normal level of´ 3.72mg% in mean value of the total cases, with the result of slight deficient condition by the loading, also the tendency of exogenous deficiency to Group B was disclosed.
5) The level of the pyruvic acid contents in blood´ which had been slightly raised (1.O8mg% in mean value) than normal before the treatment of Vitamin B complex administration and decreased slightly(to 1.Olmg %) after treatment. The contents in spinal fluid showed slightly higher level (1.11mg,%)´than the level of the blood´s, before treatment.
6) As to the laboratory examination for liver functions, the amount of serum cholesterol is generally in very lower level(in 4 cases below lOOmg%) and even more lower in Group B after the treatment. The increased amount of alkaline phosphatase in serum was significant before and after, the treatment with the evidence of lower level of albumin contents and higher of gamma globulin in serum protein electrophoresis in spite of normal results of thymol turbidity, Bromsulphalein retention tests, and serum transaminase level.
It is concluded that the characteristic deficiency of Vitamin B: and B: in the series might be explained as an important causative factors of this disease. Also the deficient condition could have been influenced by some disorders of the liver function which is resulted in protein depletion rather than any organic tissue damage of the liver.
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