背景视网膜中央动脉阻塞(CRAO)导致突然,无痛视力丧失.作为急性缺血性中风的类似情况,CRAO是眼科急症,但是缺乏标准化的治疗方法。尽管报道的结果不一致,但高压氧治疗(HBOT)已被广泛使用。目的报告在三级中心接受非动脉炎性CRAOHBOT的所有患者的视力(VA)结局。方法这项回顾性研究包括2009年3月至2023年2月在葡萄牙一家医院的高压医疗单元中使用HBOT的所有CRAO且症状持续少于24小时的成年患者。患者人口统计信息,病史,眼科评估,转诊医院,时间,直到HBOT,补充治疗,HBOT会话的数量,不利影响,收集患者主观VA增益。所有患者均接受90分钟的HBOT治疗,在2.4ATA下100%氧气。主要结果是治疗前后的VA变化(dif-logMAR)。临床上显着的视力改善定义为dif-logMAR≥0.3。使用IBMSPSSStatisticsforWindows分析数据,版本29(2021年发布;IBMCorp.,Armonk,纽约,美国)(p<0.05被认为是显著的)。结果本研究共纳入114例患者;68%(n=77)为男性,平均年龄为69岁,并接受了7次HBOT会议的中位数。没有报告HBOT的严重不良反应。从症状到治疗的平均时间延迟为12小时,在84%(n=96)的患者中,基线最佳矫正视力(BCVA)为手指计数或更差.46%(n=52)的患者发生dif-logMAR≥0.3,58%(n=66)报告治疗后主观VA改善。观察到HBOT之前的BCVA(2.12±0.74)和HBOT之后的BCVA(1.67±0.74)之间的显着改善。发现VA结果与会议总数有关,年龄,肥胖,补充治疗,和樱桃红点(CRS)在演示。在解释VA结果方面,从症状到治疗的时间延迟没有显着影响。结论HBOT似乎是安全的,对非动脉炎CRAO患者的VA结局有有益的影响,特别是取决于会话的数量。患者因素,如年龄,肥胖,CRS的存在似乎也会影响VA结果。
Background Central retinal artery occlusion (CRAO) results in sudden, painless vision loss. As an analogous condition to acute ischemic stroke, CRAO is an ophthalmological emergency, but a standardized treatment is lacking. Hyperbaric oxygen therapy (HBOT) has been widely used in spite of the inconsistent results reported. Purpose To report the visual acuity (VA) outcomes in all patients submitted to HBOT with non-arteritic CRAO in a tertiary center. Methods This retrospective
study included all adult patients with CRAO and symptoms lasting for less than 24 hours who were prescribed HBOT in the Hyperbaric Medicine Unit of a Portuguese hospital from March 2009 to February 2023. Patient demographic information, medical history, ophthalmologic evaluation, hospital of referral, time until HBOT, supplementary treatments, number of HBOT sessions, adverse effects, and patient subjective VA gain were collected. All patients were subjected to 90-minute HBOT sessions with 100% oxygen at 2.4 ATA. The primary outcome was VA change (dif-logMAR) before and after treatment. A clinically significant visual improvement was defined as a dif-logMAR≥0.3. Data were analyzed using IBM SPSS Statistics for Windows, Version 29 (Released 2021; IBM Corp., Armonk, New York, United States) (p<0.05 is considered significant). Results A total of 114 patients were included in this
study; 68% (n=77) were male, with a mean age of 69 years, and were subjected to a median number of seven HBOT sessions. No serious adverse effects from HBOT were reported. The mean time delay from symptoms to treatment was 12 hours, and best-corrected visual acuity (BCVA) at baseline was counting fingers or worse in 84% (n=96) of the patients. A dif-logMAR≥0.3 occurred in 46% (n=52) of the patients, and 58% (n=66) reported subjective VA improvement after the treatment. A significant improvement between BCVA before HBOT (2.12±0.74) and after HBOT (1.67±0.74) was observed. The VA outcome was found to be related to the total number of sessions, age, obesity, supplementary treatments, and cherry-red spot (CRS) at presentation. There were no significant effects of the time delay from symptoms to treatment in the explanation of the VA outcome. Conclusions HBOT appears to be safe and has a beneficial effect on VA outcomes in patients with non-arteritic CRAO, particularly depending on the number of sessions. Patient factors such as age, obesity, and the presence of CRSs also appear to influence the VA outcome.