Vucetic M, Jensen P K, Jansen E C
HOC-centret, Rigshospitalet, Copenhagen, Denmark.
Br J Ophthalmol. 2004 Jun;88(6):771-5. doi: 10.1136/bjo.2003.018788.
To quantify retinal vascular change during and after hyperbaric oxygenation (HO) for 6x5 weekly 90 minute treatments.
Fundus photographs were taken before, during, and after HO at 2.5 atmospheres absolute pressure (ATA) on days 1, 2, 3, 10, 20, 29, and 30 of treatment on three patients using a specially developed hand held ophthalmoscope with a digital colour camera. Blood vessel diameter was estimated on red free retinal images. The mean of three measurements of arterioles and venoles close to the optic disc was calculated. Consistency and repeatability of the method was verified by estimating the diameter of the vessels by three measurements in each of seven images taken within 70 seconds on the same person. Analysis of variance with Bonferroni correction for multiple comparisons was conducted to ascertain whether significant intergroup differences existed.
Breathing 100% oxygen at 2.5 ATA constricts retinal arterioles by 9.6% (standard deviation 0.3%) and venoles by 20.6% (SD 0.3%) of their size in air at ambient pressure. Constriction escalates during treatment. Ten minutes after the HO, arterioles dilate to 94.5% (SD 0.3%) and venoles to 89.0% (SD 0.3%) of their primary size. This pattern is the same for each day of measurement. Heart frequency falls continually during HO. Systolic, diastolic, and mean arterial pressures stay constant.
Exposure to hyperbaric oxygen causes constriction of the retinal vessels. It is found that this constriction is constant through the series of treatments. This suggests that oxygen or products thereof are responsible for the vascular changes during and after hyperbaric oxygenation probably through autoregulation of the retinal vessels.
对每周5天、共6周、每次90分钟的高压氧治疗期间及之后的视网膜血管变化进行量化。
在3名患者接受治疗的第1、2、3、10、20、29和30天,使用配备数字彩色相机的特制手持检眼镜,于绝对压力2.5个大气压(ATA)下进行高压氧治疗前、治疗期间及治疗后拍摄眼底照片。在无赤光视网膜图像上估计血管直径。计算靠近视盘的小动脉和小静脉三次测量值的平均值。通过在同一人70秒内拍摄的7张图像中对血管直径进行三次测量来估计,验证该方法的一致性和可重复性。采用方差分析并进行Bonferroni校正以进行多重比较,确定组间是否存在显著差异。
在2.5 ATA下呼吸100%氧气会使视网膜小动脉在常压空气中的大小收缩9.6%(标准差0.3%),小静脉收缩20.6%(标准差0.3%)。治疗期间收缩程度加剧。高压氧治疗后10分钟,小动脉扩张至其初始大小的94.5%(标准差0.3%),小静脉扩张至89.0%(标准差0.3%)。这种模式在每天的测量中都是相同的。高压氧治疗期间心率持续下降。收缩压、舒张压和平均动脉压保持恒定。
暴露于高压氧会导致视网膜血管收缩。发现这种收缩在一系列治疗过程中是持续存在的。这表明氧气或其产物可能通过视网膜血管的自动调节导致高压氧治疗期间及之后的血管变化。