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Damian Szczepanik-Post trauma optic atrophy-(Poland)-Posted on December.13th, 2016

Author Zhangqi Views Posted at 2016/12/13

Name: Damian Szczepanik
Sex: Male
Nationality: Polish
Age: 30Y
Diagnosis: Post trauma optic atrophy
Date of Admission: October 21th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
One year ago, (11,2015), Damian had a car accident and had ventriculoperitoneal shunts and a lumbar puncture, as well as enterocoelia surgeries. When he woke up, he had lost the sight in his right eye. His left eye was able to perceive light, and was able to distinguish between big objects at a close distance. He underwent several acupuncture therapies but there was no improvement. He took Nicergoline, Pentoxifylline and some other medications orally accompanied with eye drops. At present, his right eye is blind and dry. The right side of his face is numb. His left eye has a slight sense of light. He is able to see big objects moving in front of his eyes at a distance of 30cm. He decided to come to our hospital in hopes of having a better life. Damian was in good spirits. His nutrition, urination and bowel movements were normal.

Admission PE:
BP: 129/83mmHg; HT: 72/min; Breathing rate: 18/min. Temperature: 36.7. Height: 176cm; WT: 69kg. Damian’s body weight was normal with no malnutrition. His skin was intact, with no petechia. His thorax was symmetrical. The respiratory sounds  in both lungs were clear, with no dry or moist rales. The heartbeat was strong and regular, without obvious murmur in the valves. In the middle of the abdomen, there is a surgical scar 15cms long. The abdomen was soft and flat. The liver and spleen were normal. There was no swelling in the lower limbs.

Nervous System Examination:
Damian was alert and in good spirits. He spoke fluently. His memory, calculation ability, and orientation were normal. The diameter of the right pupil was 3.0mm, the left pupil was 6mm. The bilateral direct and indirect light reflex was gone. The left eye had perception of light, and he could perceive a big object moving in front of him at a distance of 30 cms. His right eyeball could not move outward or move freely in other directions. The left eyeball could move freely. Both eyes had no observable nystagmus or high intraocular pressure. Under ophthalmoscope: left eye: the fundus was a dark red color, the optic nerve head was pale, the macula’s boundary was not clear. The arteriole to venule ratio (AVR): 2:3. Right eye: the fundus was a dark red color. AVR: 2:3. The optic nerve head was pale with no swelling. Thee macula was not observable. The forehead wrinkle pattern was symmetrical. The right side nasolabial groove was shallower than the left side. When he showed his teeth, his mouth deviated to the left side. The tongue was centered when he extended it outward. The neck moved freely. The muscle tone of all four legs was normal, and the muscle strength of all four limbs was normal. The abdominal reflex was normal. The bilateral biceps reflex, radial periosteal reflex and bilateral triceps reflex were normal. The bilateral patellar tendon reflex was normal. The bilateral pathologic reflex was normal. The left side of the face had hypaesthesia. The deep and shallow sensory ability was normal. The coordination movements were normal.

Treatment:
Damian was diagnosed with post trauma optic nerve atrophy. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged optic nerves, replace the dead nerves with new injected stem cells, nourish the nerves and improve blood circulation. This was accompanied with rehabilitation.               

Post-treatment:
After 14 days of treatment, the pupil of the right eye occasionally had reflex, but very slow and delayed. The distance that the left eye could perceive something moving extended to 40cm. The dark adaptability has improved. The left eye has become more sensitive to light. The numbness of right side of the face has been alleviated. The dry condition of the right eye had improved. Under ophthalmoscope: left eye: the fundus turned from dark red to orange. The color of the optic nerve head is not as pale. The boundary of the macula is clear.

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