Evaluation of Retinal Arterial Occlusion and its Visual and Systemic Prognosis after Hyperbaric Oxygen Therapy.

IF 2.3 2区医学 Q2 OPHTHALMOLOGY Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2024-08-14 DOI:10.1097/IAE.0000000000004253

Fritz Gerald P Kalaw, Nicholas Chartrand, Lauren Wedekind, Jimmy S Chen, Andrew C Lin, Zachary Koretz, Leo Meller, Michael Oca, Vasan Jagadeesh, Katherine Wilson, Evan Walker, William R Freeman, Christopher B Toomey

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Abstract

Purpose: To evaluate the systemic and ocular outcomes of patients with branch retinal artery occlusion (BRAO) and central retinal artery occlusion (CRAO) after hyperbaric oxygen therapy (HBOT).

Methods: This is a single-institution study of 75 subjects diagnosed with BRAO (28, 37.3%) and CRAO (47, 62.7%) who visited the emergency department or stroke clinic. Twenty-seven (36%) subjects received HBOT on initial presentation (BRAO-14.3%, CRAO-48.9%). The primary outcome was the best corrective visual acuity (BCVA) change in non-HBOT and HBOT subjects. Secondary outcomes included subsequent development of an acute cerebrovascular accident (CVA)/stroke or neovascular glaucoma (NVG).

Results: Overall BCVA did not change from the initial presentation to the final timepoint (logMAR 1.5) in either the conservative management or HBOT cohorts for either BRAO subjects (non-HBOT-logMAR 0.4 vs. 0.6, p=0.658; HBOT-logMAR 0.1 vs. 0.4, p=0.207) or CRAO subjects (non-HBOT-logMAR 2.1 vs. 2.2, p=0.755; HBOT-logMAR 2.1 vs. 2.0, p=0.631). Seven (9.3%) subjects developed CVA (BRAO: non-HBOT-4.2% and HBOT-25.0%, p=0.207; CRAO: non-HBOT-16.7% and HBOT-4.3%, p=0.348) and five subjects (6.7%) developed NVG (BRAO: non-HBOT-4.2% and HBOT-0%, p=1.00; CRAO: non-HBOT-16.7% and HBOT-0%, p=0.109).

Conclusions: Our findings suggest that HBOT does not significantly improve BCVA or mitigate the subsequent development of stroke and NVG in patients with RAOs.

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评估视网膜动脉闭塞及其在高压氧治疗后的视觉和全身预后。

目的：评估视网膜分支动脉闭塞（BRAO）和视网膜中央动脉闭塞（CRAO）患者接受高压氧治疗（HBOT）后的全身和眼部疗效：这是一项单机构研究，研究对象为 75 名到急诊科或中风诊所就诊的确诊为 BRAO（28 人，占 37.3%）和 CRAO（47 人，占 62.7%）的患者。27 名受试者（36%）在初次就诊时接受了 HBOT 治疗（BRAO-14.3%，CRAO-48.9%）。主要结果是非 HBOT 和 HBOT 受试者的最佳矫正视力 (BCVA) 变化。次要结果包括随后发生急性脑血管意外（CVA）/中风或新生血管性青光眼（NVG）：在保守治疗组和 HBOT 组中，无论是 BRAO 受试者（非 HBOT-ogMAR 0.4 vs. 0.6，p=0.658；HBOT-logMAR 0.1 vs. 0.4，p=0.207）还是 CRAO 受试者（非 HBOT-ogMAR 2.1 vs. 2.2，p=0.755；HBOT-logMAR 2.1 vs. 2.0，p=0.631），从初次发病到最终时间点（logMAR 1.5），总体 BCVA 均无变化。7名受试者（9.3%）出现了CVA（BRAO：非HBOT-4.2%和HBOT-25.0%，p=0.207；CRAO：非HBOT-16.7%和HBOT-4.3%，p=0.348），5名受试者（6.7%）出现了NVG（BRAO：非HBOT-4.2%和HBOT-0%，p=1.00；CRAO：非HBOT-16.7%和HBOT-0%，p=0.109）：我们的研究结果表明，HBOT 并不能显著改善 RAO 患者的 BCVA，也不能减轻中风和 NVG 的后续发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.