Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Takaoka City Hospital, 4-1 Takaramachi, Takaoka-Shi, Toyama, 933-8550, Japan.
Int Ophthalmol. 2024 Nov 9;44(1):419. doi: 10.1007/s10792-024-03335-y.
To assess and compare the efficacy of three treatment modalities for central retinal artery occlusion (CRAO): conservative therapy, hyperbaric oxygen therapy (HBOT), and endovascular retinal surgery (ERS).
We retrospectively analyzed the cases of CRAO patients treated at the Toyama University Hospital. Their age range was 44-87 years; a balanced gender distribution was observed. The conservative therapy group included 13 eyes (6 males, 7 females, average age 74 years). HBOT group: 11 eyes from 10 patients (5 males, 5 females, average age 70 years). ERS group: 10 eyes (7 males, 3 females, average age 74 years). The treatments were as follows. Conservative group: ocular massage and sublingual nitroglycerin. HBOT: 60-min sessions at 2 atmospheres. ERS: vitrectomy followed by tissue plasminogen activator injection using a 47-ga. microneedle. Visual acuity was assessed using logMAR units, with statistical analyses by paired t-test, Kruskal-Wallis test, and Mann-Whitney U-test with Bonferroni correction.
The conservative group showed a slight visual acuity change from 1.96 ± 0.53 to 1.88 ± 0.56 (p = 0.56). The HBOT group exhibited a significant improvement from 1.79 ± 0.80 to 1.28 ± 0.81 (p = 0.007). The ERS group displayed the most substantial improvement, with scores moving from 1.98 ± 0.36 to 0.68 ± 0.49 (p = 0.0000413). The ERS group's outcomes were significantly superior to those of the other groups.
These results suggest that while conservative treatment may not be sufficient, both HBOT and endovascular retinal surgery show promise, with the latter demonstrating the most significant improvement.
评估和比较三种治疗方法治疗视网膜中央动脉阻塞（CRAO）的疗效：保守治疗、高压氧治疗（HBOT）和血管内视网膜手术（ERS）。
我们回顾性分析了在富山大学医院接受治疗的 CRAO 患者。他们的年龄范围为 44-87 岁；观察到性别分布均衡。保守治疗组包括 13 只眼（6 名男性，7 名女性，平均年龄 74 岁）。HBOT 组：10 名患者的 11 只眼（5 名男性，5 名女性，平均年龄 70 岁）。ERS 组：10 只眼（7 名男性，3 名女性，平均年龄 74 岁）。治疗如下。保守组：眼球按摩和舌下硝酸甘油。HBOT：2 个大气压下 60 分钟。ERS：玻璃体切割术，然后使用 47-ga 微针注射组织纤溶酶原激活剂。视力采用 logMAR 单位评估，统计学分析采用配对 t 检验、Kruskal-Wallis 检验和 Mann-Whitney U 检验，并用 Bonferroni 校正。
保守组视力从 1.96±0.53 略有改善至 1.88±0.56（p=0.56）。HBOT 组从 1.79±0.80 显著改善至 1.28±0.81（p=0.007）。ERS 组的改善最为显著，评分从 1.98±0.36 提高至 0.68±0.49（p=0.0000413）。ERS 组的结果明显优于其他组。
这些结果表明，虽然保守治疗可能不够，但 HBOT 和血管内视网膜手术都有希望，后者显示出最显著的改善。
