高压氧治疗后视网膜动脉阻塞及其视力和全身预后的评估。
Evaluation of Retinal Arterial Occlusion and its Visual and Systemic Prognosis after Hyperbaric Oxygen Therapy.
作者信息
Kalaw Fritz Gerald P, Chartrand Nicholas, Wedekind Lauren, Chen Jimmy S, Lin Andrew C, Koretz Zachary, Meller Leo, Oca Michael, Jagadeesh Vasan, Wilson Katherine, Walker Evan, Freeman William R, Toomey Christopher B
机构信息
Jacobs Retina Center, University of California San Diego, California, United States of America, 92093.
Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, California, United States of America, 92093.
出版信息
Retina. 2024 Aug 14. doi: 10.1097/IAE.0000000000004253.
PURPOSE
To evaluate the systemic and ocular outcomes of patients with branch retinal artery occlusion (BRAO) and central retinal artery occlusion (CRAO) after hyperbaric oxygen therapy (HBOT).
METHODS
This is a single-institution study of 75 subjects diagnosed with BRAO (28, 37.3%) and CRAO (47, 62.7%) who visited the emergency department or stroke clinic. Twenty-seven (36%) subjects received HBOT on initial presentation (BRAO-14.3%, CRAO-48.9%). The primary outcome was the best corrective visual acuity (BCVA) change in non-HBOT and HBOT subjects. Secondary outcomes included subsequent development of an acute cerebrovascular accident (CVA)/stroke or neovascular glaucoma (NVG).
RESULTS
Overall BCVA did not change from the initial presentation to the final timepoint (logMAR 1.5) in either the conservative management or HBOT cohorts for either BRAO subjects (non-HBOT-logMAR 0.4 vs. 0.6, p=0.658; HBOT-logMAR 0.1 vs. 0.4, p=0.207) or CRAO subjects (non-HBOT-logMAR 2.1 vs. 2.2, p=0.755; HBOT-logMAR 2.1 vs. 2.0, p=0.631). Seven (9.3%) subjects developed CVA (BRAO: non-HBOT-4.2% and HBOT-25.0%, p=0.207; CRAO: non-HBOT-16.7% and HBOT-4.3%, p=0.348) and five subjects (6.7%) developed NVG (BRAO: non-HBOT-4.2% and HBOT-0%, p=1.00; CRAO: non-HBOT-16.7% and HBOT-0%, p=0.109).
CONCLUSIONS
Our findings suggest that HBOT does not significantly improve BCVA or mitigate the subsequent development of stroke and NVG in patients with RAOs.
目的
评估高压氧治疗（HBOT）对视网膜分支动脉阻塞（BRAO）和视网膜中央动脉阻塞（CRAO）患者的全身及眼部预后。
方法
这是一项在单一机构开展的研究，纳入了75名诊断为BRAO（28例，37.3%）和CRAO（47例，62.7%）并前往急诊科或卒中门诊就诊的患者。27名（36%）患者在初次就诊时接受了HBOT（BRAO患者中接受HBOT的比例为14.3%，CRAO患者中接受HBOT的比例为48.9%）。主要结局指标为未接受HBOT和接受HBOT患者的最佳矫正视力（BCVA）变化。次要结局指标包括随后发生急性脑血管意外（CVA）/卒中或新生血管性青光眼（NVG）。
结果
无论是BRAO患者（未接受HBOT组：logMAR从0.4变为0.6，p = 0.658；接受HBOT组：logMAR从0.1变为0.4，p = 0.207）还是CRAO患者（未接受HBOT组：logMAR从2.1变为2.2，p = 0.755；接受HBOT组：logMAR从2.1变为2.0，p = 0.631），从初次就诊到最终时间点，总体BCVA均未改变（logMAR为1.5）。7名（9.3%）患者发生了CVA（BRAO患者：未接受HBOT组为4.2%，接受HBOT组为25.0%，p = 0.207；CRAO患者：未接受HBOT组为16.7%，接受HBOT组为4.3%，p = 0.348），5名（6.7%）患者发生了NVG（BRAO患者：未接受HBOT组为4.2%，接受HBOT组为0%，p = 1.00；CRAO患者：未接受HBOT组为16.7%，接受HBOT组为0%，p = 0.109）。
结论
我们的研究结果表明，HBOT并不能显著改善RAO患者的BCVA，也不能减轻其随后发生卒中及NVG的风险。
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