中央视网膜动脉阻塞管理的全国发病率和趋势:5000名患者的分析
Galadu Subah1, Patricia Xu2, Sabrina Zeller1
1From the Department of Neurosurgery, Westchester Medical Center, Valhalla, NY.
Cardiology in review
|April 26, 2024
概括
中央视网膜动脉封闭 (CRAO) 患者比中风患者接受了较少的静脉注射高高酶 (tPA) 和机械血栓切除 (MT) 治疗. 虽然CRAO患者有更好的结果和更少的并发症,但干预措施并没有显著减少严重失明.
科学领域:
- 眼科医生 眼科 眼科
- 血管神经学 血管神经学
- 干预心脏病学 干预心脏病学
背景情况:
- 中央视网膜动脉封闭 (CRAO) 是一种罕见的血管事件,导致严重的视力丧失.
- 与急性缺血性中风的相似之处表明,静脉输入高高血酶 (tPA) 和机械血栓切除术 (MT) 有潜在的益处.
- 然而,有限的数据和风险使得CRAO的干预效用变得不确定.
研究的目的:
- 评估tPA和MT在CRAO患者中的利用和结果.
- 将接受这些干预的CRAO患者与急性缺血性中风患者进行比较.
主要方法:
- 使用了国家住院患者样本数据库 (2010-2019).
- 使用ICD代码识别了CRAO和急性缺血性中风的患者.
- 分析了人口统计数据,干预率,并发症和功能结果.
主要成果:
- 与中风患者相比,CRAO队列 (5009名患者) 较年轻,肥胖,高血压和抗凝固剂/烟草使用率较高.
- CRAO患者接受tPA的频率较少 (3.41%对6.21%) 和MT甚至更少 (0.38%对1.31%).
- CRAO患者的并发症较少,功能不良的结果较少 (31.74%与58.1%相比),住院死亡率降低 (1.2%与5.64%),但严重失明率较高 (9.24%与0.58%).
结论:
- 与中风患者相比,CRAO患者表现出不同的风险因素,并且在医院治疗的结果通常更好.
- 目前的数据不显示tPA/MT和CRAO中减少深度失明之间的显著关联,可能是由于干预样本大小小小.
- 需要对更大的队列和新疗法进行进一步的研究,以优化CRAO中的视觉恢复.
相关概念视频
Glaucoma: Overview
1.7K
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
1.7K
Open Angle Glaucoma: Treatment
1.1K
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
1.1K
Angle Closure Glaucoma: Treatment
1.7K
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
1.7K
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
773
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
773
Aneurysm III: Interprofessional Care
478
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
478


