Kadam Yogita, Das Anthony V, Narayanan Raja, Balakrishnan Neelima, Telukunta Praneet, Takkar Brijesh
Department of Eyesmart EMR and AEye, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
Indian Health Outcomes, Public Health, and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2025 Jan 1;73(Suppl 1):S72-S77. doi: 10.4103/IJO.IJO_1686_24. Epub 2024 Dec 24.
To evaluate the clinical profile of retinal artery occlusion (RAO) and impact of presentation on visual outcomes.
A retrospective analysis of case files of 3070 patients with RAO was performed using electronic medical records.
Demographic data were analyzed using descriptive statistics. The differential distribution of risk factors of RAO with age was studied. Time to presentation and treatment effects were assessed using multivariate regression. Interaction plots were drawn to assess the impact of risk factors on outcomes.
Central RAO was the most common type (n = 2443, 77.11%), followed by branch RAO (n = 500, 15.78%), while combined retinal vascular occlusion and cilio-RAO were rare. Most of the patients (71.40%) were male and had unilateral (96.81%) affliction. Almost half presented within the fifth (24.85%) and sixth (21.4%) decades of life. Hyperhomocysteinemia had a higher association (1.95, P = 0.0019) with younger patients (<40 years), while hypertension (3.64, P < 0.001), diabetes mellitus (DM; 4.18, P < 0.001), and coronary artery disease (CAD) (4.26, P = 0.002) were significantly commoner in older patients. CAD (5.1%) and cerebrovascular disease (0.6%) were detected after ocular presentation in some patients. Embolus, though detected rarely (1%), was associated (60%) with serious systemic disorders. Early presentation (<6 h) was associated with better visual outcomes (mean log of minimum angle of resolution 1.8 ± 1.3 vs. 2.1 ± 1.3, P = 0.032). Neovascular glaucoma (2.14% overall) was twice more common in DM (P < 0.0004) and led to further vision loss. Visual improvement occurred in 10% of patients over follow-up.
RAO occurs slightly earlier compared to coronary and cerebrovascular disorders and can precede their detection. Associated risk factors vary with the age of presentation. Presentation within 6 h needs facilitation for better outcomes and management.
评估视网膜动脉阻塞（RAO）的临床特征以及就诊情况对视力预后的影响。
利用电子病历对3070例RAO患者的病例档案进行回顾性分析。
采用描述性统计分析人口统计学数据。研究RAO危险因素随年龄的差异分布。使用多因素回归评估就诊时间和治疗效果。绘制交互图以评估危险因素对预后的影响。
中央性RAO是最常见的类型（n = 2443，77.11%），其次是分支性RAO（n = 500，15.78%），而视网膜血管联合阻塞和睫状视网膜动脉阻塞则较为罕见。大多数患者（71.40%）为男性，且为单侧患病（96.81%）。几乎一半的患者在第五个十年（24.85%）和第六个十年（21.4%）发病。高同型半胱氨酸血症在年轻患者（<40岁）中关联度更高（1.95，P = 0.0019），而高血压（3.64，P < 0.001）、糖尿病（DM；4.18，P < 0.001）和冠状动脉疾病（CAD）（4.26，P = 0.002）在老年患者中明显更为常见。部分患者在眼部发病后检测出CAD（5.1%）和脑血管疾病（0.6%）。栓子虽很少被检测到（1%），但与严重的全身性疾病相关（60%）。早期就诊（<6小时）与更好的视力预后相关（最小分辨角的平均对数1.8±1.3 vs. 2.1±1.3，P = 0.032）。新生血管性青光眼（总体为2.14%）在DM患者中更为常见（P < 0.0004），并导致视力进一步丧失。随访期间10%的患者视力有所改善。
与冠状动脉和脑血管疾病相比，RAO发病稍早，且可能先于它们被发现。相关危险因素随发病年龄而异。6小时内就诊有助于获得更好的预后和治疗效果。
