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败血性洞穴鼻腔血栓症:临床特征,管理和结果
Omar Halawa1, Alison Gibbons, Alexandra Van Brummen
1Wilmer Eye Institute (QH, AG, EL), Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Ophthalmology (AVB), University of Washington School of Medicine, Seattle, Washington.
概括
败血性洞腔鼻血栓 (CST) 可以导致近三分之一的患者永久视力丧失. 呈现时的相对 afferent瞳孔缺陷 (RAPD) 表明在败血性CST中视力和生存结果较差的风险更高.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 传染性疾病 传染性疾病
背景情况:
- 败血性洞腔鼻血栓症 (CST) 是一种罕见的疾病,在历史上患病率和死亡率很高.
- 最近的数据表明更有利的结果,需要对临床特征和预后因素的最新理解.
- 需要进行综合性评估,以指导当代的败血性CST的管理.
研究的目的:
- 为了评估临床特征和预后因素的视觉和生存结果在败血性CST.
- 为了解和指导这种罕见疾病的管理策略.
主要方法:
- 一项多中心的回顾性队列研究分析了2000年至2021年期间的27名成像确认的败血性CST患者.
- 数据包括人口统计,感染细节,眼科发现 (BCVA,RAPD,IOP,EOM) 和管理 (抗菌药物,抗凝,手术).
- 主要结局是最终的眼科发现和同住院死亡率.
主要成果:
- 在介绍时,8.7%的人有NLP视觉,29.6%的人有RAPD,73.9%的人有EOM限制,54.2%的人增加了IOP.
- 死亡率为11.1%,其中死亡率为11.1%. 在随访时,16.7%的人有NLP视觉,23.8%的人有持续的RAPD,31.8%的人有持续的EOM限制.
- 在呈现时患有RAPD的患者的最终BCVA显著恶化,死亡率更高 (37.5%与0.0%,P<0.01).
结论:
- 败血性CST在近三分之一的病例中可能导致永久的眼科缺陷,在当前的治疗下,死亡率约为11%.
- 呈现时出现的新相对形瞳孔缺陷 (RAPD) 是视力和生存结果差的重要风险因素.
- 早期识别RAPD对于风险分层和感染性CST的管理至关重要.
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