Lopes Ana Sofia, Basto Rita, Henriques Susana, Colaço Luísa, Costa E Silva Filomena, Prieto Isabel, Guerreiro Francisco
Department of Ophthalmology of Professor Doutor Fernando Fonseca E.P.E. Hospital (Amadora-Sintra), Lisbon, Portugal.
Underwater and Hyperbaric Medicine Center, Armed Forces Hospital-Lisbon Pole, Lisbon, Portugal.
Case Rep Ophthalmol Med. 2019 Dec 28;2019:9765938. doi: 10.1155/2019/9765938. eCollection 2019.
To evaluate the efficacy and safety of hyperbaric oxygen therapy (HBOT) in patients with acute retinal artery occlusion (RAO). Secondarily, to analyse the epidemiology and the clinical approach.
Retrospective study of 13 patients submitted to HBOT between 2013 and 2018. The analysed parameters consisted of: systemic history, time between symptoms onset and treatment, initial approach, number of HBOT sessions, complications of HBOT and best corrected visual acuity-BCVA (of the total sample, central RAO-CRAO-group, and branch RAO-BRAO group).
Arterial hypertension was the most prevalent systemic risk factor (53.8%). Initial therapies were 100% normobaric oxygen administration, topical and oral hypotensive medication, eye massage and aspirin. CRAO was observed in 69.2% and BRAO in 30.8% of the cases, with clinically significant visual improvement (a decrease in logMAR of 0.3) in 55.5% and 75%, respectively. Time between symptoms onset and treatment had a median of 9 hours. The median number of HBOT sessions was 7, without complications.
HBOT provide BCVA improvement in patients with RAO, when it is performed in an early time after the symptom onset. It seems to be an effective and safe therapeutic option for a pathology that still remains without approved treatment.
评估高压氧疗法(HBOT)对急性视网膜动脉阻塞(RAO)患者的疗效和安全性。其次,分析其流行病学及临床治疗方法。
对2013年至2018年间接受HBOT治疗的13例患者进行回顾性研究。分析的参数包括:全身病史、症状发作与治疗之间的时间、初始治疗方法、HBOT治疗次数、HBOT并发症以及最佳矫正视力(BCVA,包括总样本、视网膜中央动脉阻塞-CRAO-组和视网膜分支动脉阻塞-BRAO组)。
动脉高血压是最常见的全身危险因素(53.8%)。初始治疗方法为100%常压吸氧、局部和口服降压药物、眼部按摩及阿司匹林。69.2%的病例为CRAO,30.8%为BRAO,分别有55.5%和75%的患者视力得到临床显著改善(logMAR降低0.3)。症状发作与治疗之间的时间中位数为9小时。HBOT治疗次数中位数为7次,无并发症发生。
症状发作后早期进行HBOT可改善RAO患者的BCVA。对于尚无获批治疗方法的该病症而言,HBOT似乎是一种有效且安全的治疗选择。