高压氧治疗视网膜中央动脉闭塞的疗效：单中心经验。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-04 DOI:10.1016/j.ajo.2024.09.027

BOYOUNG M. KIM , KENNY Y. WANG , TIMOTHY T. XU , SARA J. HOOSHMAND , GARY N. TOUPS , MARTHA P. MILLMAN , LAWRENCE W. STEINKRAUS , ANDREA A. TOOLEY , ANDREW J. BARKMEIER , JOHN J. CHEN

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引用次数: 0

摘要

目的：描述一家三级医疗中心对视网膜中央动脉闭塞（CRAO）患者进行高压氧治疗（HBOT）的效果：设计：回顾性临床队列研究：回顾2009年1月1日至2020年12月31日期间在明尼苏达州罗切斯特梅奥诊所接受HBOT治疗的所有CRAO患者的病历，以确认诊断、发病时间、检查结果、治疗方法和随访数据。主要结果指标包括最终视力（VA）和改善线数：结果：在12年的研究期间，共有41名确诊为CRAO的患者接受了HBOT治疗。从症状出现到接受 HBOT 治疗的中位时间为 9.5 小时（四分位数间距 [IQR] 6.5 - 14.0 小时），患者接受 HBOT 治疗的中位次数为 4 次（IQR 2.5 - 6.0 次）。有 20 名患者在 9 小时内接受了 HBOT 治疗，其中 14 人（70%）的视力改善≥0.3 logMAR，具有临床意义。相比之下，在 9 小时后接受治疗的 21 名患者中，有 6 人（28.6%）的视力改善幅度≥0.3 logMAR（P=0.008）。所有患者发病时的视力中位数对数马尔值为 2.00（IQR 1.70，2.30），随访时的视力中位数对数马尔值为 1.94（IQR 1.00，2.00）（p9 小时后症状发作分别为 5.9（IQR 3.0，10.0）和 0.0（IQR 0.0，3.0）（p结论：在接受早期 HBOT 治疗的 CRAO 患者中，接受 HBOT 治疗后 VA 有明显的统计学改善，其中在 9 小时内接受治疗的患者获益最大。需要对 CRAO 患者进行随机对照试验，以确认 HBOT 的疗效。

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Outcomes of Hyperbaric Oxygen Treatment for Central Retinal Artery Occlusion: A Single Center Experience

Purpose

To describe the outcomes of hyperbaric oxygen therapy (HBOT) for patients with central retinal artery occlusion (CRAO) at a single tertiary care center.

Design

Retrospective clinical cohort study.

Methods

Medical records of all patients diagnosed with CRAO who received HBOT at Mayo Clinic in Rochester, Minnesota from January 1, 2009 to December 31, 2020 were reviewed to confirm diagnosis, time from onset to presentation, exam findings, treatments, and follow-up data. Main outcome measures included final visual acuity (VA) and number of lines of improvement.

Results

There were 41 patients diagnosed with CRAO who received HBOT during the 12-year study period. Median time from symptom onset to HBOT treatment was 9.5 h (interquartile range [IQR] 6.5, 14.0 h), and patients received a median of 4 HBOT sessions (IQR 2.5, 6.0 sessions). There were 20 patients who received HBOT within 9 h, 14 (70%) of which had clinically meaningful improvement in VA of ≥0.3 logMAR. In comparison, of the 21 patients treated after 9 h, 6 (28.6%) had VA improvement of ≥0.3 logMAR (P = .008). For all patients, the median logMAR VA at presentation was 2.00 (IQR 1.70, 2.30) and the median logMAR VA at follow-up was 1.94 (IQR 1.00, 2.00) (P < .001), with median lines of improvement of 3.0 (IQR 0.0, 7.0). For patients treated within 9 h, the median logMAR VA at presentation was 2.00 (IQR 1.93, 2.30) and the median logMAR VA at follow-up was 1.70 (IQR 0.54, 2.00). Patients treated within 9 h had statistically significant greater median lines of VA improvement than cases that were treated after >9 h from symptom onset at 5.9 (IQR 3.0, 10.0) and 0.0 (IQR 0.0, 3.0), respectively (P < .001). There was no difference in VA recovery associated with specific retinal exam findings such as cherry-red spot (P = .22) and cilioretinal artery perfusion (P = .36) compared to patients without those findings.

Conclusion

There was a statistically significant improvement in VA after HBOT treatment in CRAO patients among patients that received early HBOT, with patients receiving the most benefit when receiving treatment within 9 h. Randomized control trials in patients with CRAO are required to confirm the efficacy of HBOT.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.