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高压氧辅助治疗对视网膜中央动脉阻塞患者的影响。

The effect of adjunctive hyperbaric oxygen therapy in patients with central retinal artery occlusion.

机构信息

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

出版信息

Undersea Hyperb Med. 2020 First Quarter;47(1):57-64. doi: 10.22462/01.03.2020.7.

Abstract

PURPOSE

Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor prognosis, despite diligent conventional treatment. According to the clinical recommendations of the Undersea and Hyperbaric Medical Society, hyperbaric oxygen (HBO2) is a potentially beneficial treatment; however, the benefit of adjunctive HBO2 in patients with CRAO in Korea remains unclear. The present study aimed to evaluate the effect of adjunctive HBO2 in patients with CRAO.

METHODS

This registry-based observational study included adult patients who presented to the emergency department or ophthalmology outpatient department within 24 hours of the onset of CRAO symptoms. Data of patients from October 2016 to February 2019 were analyzed. The patients were categorized into two groups according to the use of adjunctive HBO2: no HBO2 and HBO2.

RESULT

During the study period, 34 consecutive patients were enrolled, of which 19 were included in the study. In the total cohort, 10 patients (52.6%) were treated with adjunctive HBO2. There were no statistically significant differences in terms of age, sex, comorbidities, duration from symptoms onset to hospital visit, presence of the cilioretinal artery, and use of anterior chamber paracentesis between the two groups. The HBO2 group showed significantly higher change in best-corrected visual acuity than the no HBO2 group (p=0.043).

CONCLUSION

Patients with CRAO in the HBO2 group showed significantly greater visual improvement than those in the no-HBO2 group. Clinicians should consider adjunctive HBO2 in the treatment approach in patients with CRAO who visit the hospital within 24 hours of symptoms onset.

摘要

目的

尽管进行了积极的常规治疗,中央视网膜动脉阻塞(CRAO)仍是一种预后不良的眼科急症。根据海洋和高压医学学会的临床建议,高压氧(HBO2)是一种潜在有益的治疗方法;然而,在韩国,CRAO 患者接受辅助 HBO2 治疗的益处尚不清楚。本研究旨在评估辅助 HBO2 治疗 CRAO 患者的效果。

方法

本基于登记的观察性研究纳入了发病 24 小时内就诊于急诊或眼科门诊的成年 CRAO 患者。分析了 2016 年 10 月至 2019 年 2 月的数据。根据是否使用辅助 HBO2 将患者分为两组:无 HBO2 组和 HBO2 组。

结果

在研究期间,连续纳入了 34 例患者,其中 19 例纳入了本研究。在总队列中,有 10 例(52.6%)患者接受了辅助 HBO2 治疗。两组在年龄、性别、合并症、从症状发作到就诊的时间、睫状视网膜动脉的存在以及前房穿刺术的使用方面均无统计学差异。HBO2 组的最佳矫正视力改善程度明显高于无 HBO2 组(p=0.043)。

结论

在发病 24 小时内就诊的 CRAO 患者中,HBO2 组的视力改善明显优于无 HBO2 组。临床医生应考虑在发病 24 小时内就诊的 CRAO 患者的治疗方案中加入辅助 HBO2。

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