Wolf S, Hoberg A, Bertram B, Jung F, Kiesewetter H, Reim M
Augenklinik der Med. Faukultät der RWTH Aachen.
Klin Monbl Augenheilkd. 1989 Sep;195(3):154-60. doi: 10.1055/s-2008-1046428.
Forty patients (age 67 +/- 9 years) with acute central artery obstruction (CAO; n = 20) or branch artery occlusion (BAO; n = 20) of the retina were examined in a prospective study. All patients received a hypervolemic or isovolemic hemodilution, depending on their hematocrit values, for a period of ten days. Clinical, hemodynamic, and rheological data of these patients were recorded before therapy, after ten days, and after six weeks. Under this therapy the central vision of 24 patients (CAO: n = 10; BAO: n = 14) improved by two or more stages. The extent of the circulatory disturbance was determined by arteriovenous passage time and dye bolus velocity. Compared with a control group, a significantly increased arteriovenous passage time and decreased dye bolus velocity were observed initially. The values after ten days of therapy and after six weeks were significantly improved (P less than 0.01) as compared to the initial values. Patients with longer latency showed almost normal retinal hemodynamics, even without therapy, after some weeks. However, in most cases the spontaneous improvement occurred too late. Therefore, it appears important to achieve early reperfusion by therapy.
在一项前瞻性研究中，对40例视网膜急性中央动脉阻塞（CAO；n = 20）或分支动脉阻塞（BAO；n = 20）的患者（年龄67±9岁）进行了检查。所有患者根据其血细胞比容值接受了为期10天的高血容量或等血容量血液稀释。记录这些患者在治疗前、10天后和6周后的临床、血液动力学和流变学数据。在这种治疗下，24例患者（CAO：n = 10；BAO：n = 14）的中心视力提高了两个或更多阶段。循环障碍的程度通过动静脉通过时间和染料团注速度来确定。与对照组相比，最初观察到动静脉通过时间显著延长，染料团注速度降低。治疗10天后和6周后的数值与初始值相比有显著改善（P < 0.01）。潜伏期较长的患者在几周后即使未经治疗视网膜血液动力学也几乎恢复正常。然而，在大多数情况下，自发改善出现得太晚。因此，通过治疗实现早期再灌注似乎很重要。
