Rimmele David Leander, Petersen Elina L, Schrage Theresa, Härter Martin, Kriston Levente, Thomalla Götz
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurology, Luzerner Kantonsspital, Lucerne, Switzerland.
Eur Stroke J. 2025 Jan 25:23969873251314715. doi: 10.1177/23969873251314715.
We aimed to assess impairments on health-related quality of life, and mental health resulting from Retinal artery occlusion (RAO) with monocular visual field loss and posterior circulation ischemic stroke (PCIS) with full or partial hemianopia using patient-reported outcome measures (PROMs).
In a prospective study, consecutive patients with acute RAO on fundoscopy and PCIS on imaging were recruited during their surveillance on a stroke unit over a period of 15 months. Baseline characteristics were determined from medical records and interviews. Health-related quality of life (PROM Information System 10-Question-Short-Form, PROMIS-10), and mental health symptoms (Patient-Health-Questionnaire-4, PHQ-4) were assessed 3 and 12 months after admission postally and via phone.
Ffity-seven patients with RAO and 19 with isolated full or partial hemianopia determined by the NIHSS (median = 2; IQR:0/2) according to PCIS were included. Characteristics of cardiovascular risk factors, and functional status pre-stroke were comparable between the groups. At 3 months, mean ± standard deviation -scores of PROMIS physical and mental health were 47.1 ± 8.8 and 46.7 ± 8.8 for patients with RAO, and 43.4 ± 9.8 and 43.2 ± 6.2 for PCIS. Compared to 50 ± 10 in the general population, scores after RAO ( = 0.04; = 0.02) and PCIS ( = 0.01; < 0.001) were lower in both domains after 3 months. Concerning PCIS, scores in the mental health domain remained decreased at 12 months ( = 0.04). On the PHQ-4, 25% of patients with RAO, and 62% with PCIS scored indicative for anxious and/or depressive syndromes at 3 months.
RAO led only to partial and to less persistent mental impairments than PCIS. This suggests that a different approach involving complex visual and neuropsychological treatment over a longer period of time needs to be considered for post-stroke care of PCIS.
The trial was submitted at http://www.clinicaltrials.gov, under NCT03795948.
我们旨在使用患者报告结局量表（PROMs）评估视网膜动脉阻塞（RAO）伴单眼视野缺损以及后循环缺血性卒中（PCIS）伴完全或部分偏盲对健康相关生活质量和心理健康造成的损害。
在一项前瞻性研究中，在15个月的时间里，于卒中单元对通过眼底镜检查确诊为急性RAO以及通过影像学检查确诊为PCIS的连续患者进行监测。从病历和访谈中确定基线特征。在入院后3个月和12个月时，通过邮寄和电话方式评估健康相关生活质量（PROM信息系统10项简短形式，PROMIS - 10）以及心理健康症状（患者健康问卷 - 4，PHQ - 4）。
纳入了57例RAO患者以及19例根据PCIS通过美国国立卫生研究院卒中量表（NIHSS）（中位数 = 2；四分位间距：0/2）确定为孤立性完全或部分偏盲的患者。两组之间心血管危险因素特征以及卒中前功能状态具有可比性。在3个月时，RAO患者的PROMIS身体和心理健康平均±标准差得分分别为47.1±8.8和46.7±8.8，PCIS患者分别为43.4±9.8和43.2±6.2。与一般人群的50±10相比，3个月后RAO（P = 0.04；P = 0.02）和PCIS（P = 0.01；P < 0.001）在两个领域的得分均较低。关于PCIS，心理健康领域的得分在12个月时仍降低（P = 0.04）。在PHQ - 4量表上，3个月时25%的RAO患者以及62%的PCIS患者得分表明存在焦虑和/或抑郁综合征。
与PCIS相比，RAO仅导致部分且持续性较低的心理损害。这表明对于PCIS的卒中后护理，需要考虑采用一种在更长时间内涉及复杂视觉和神经心理治疗的不同方法。
