溶栓治疗在视网膜动脉阻塞中的应用进展

doi:10.6040/j.issn.1673-3770.1.2020.048

Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (4): 5-10.doi: 10.6040/j.issn.1673-3770.1.2020.048

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Application progress of thrombolysis in retinal artery occlusionYANG Ming Overview WEI Wenbin Guidance Beijing Tongren Hospital, Capital Medical University / Beijing Tongren Eye Center / Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment / Beijing Ophthalmology&Visual Sciences Key Lab / Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing 100730, ChinaAbstract:

Key words: Thrombolysis;
Retinal artery occlusion/therapy;
Arterial thrombolysis;
Intravenous thrombolysis视网膜动脉阻塞是类似于脑卒中的临床眼科急症, 其发病原因可能是栓子栓塞、血栓形成、动脉痉挛及受压等, 每年发病率约1/100 000^［1］, 临床表现为突发单眼无痛的视觉丧失, 如果不及时进行临床干预, 约80%的患者进展到视力为20/400或更低^［2］, RAO最常见的原因是栓子栓塞视网膜动脉, 溶栓治疗即激发纤溶系统, 将包裹于原发性栓子的血性栓塞物及单纯性血栓溶解而使栓子变小甚至消失, 最大减少缺血受损范围^［3］, 既往的研究表明, 视力恢复的程度往往与发生视网膜缺血的总时间相关。Hayreh等^［4］报道, 当视网膜缺血时间超过4 h, 视网膜组织RGC细胞会发生不可逆的形态学变化, 随着缺血时间增加, 视功能及神经组织的损害更严重。

Received:2019-05-26 Online:2020-07-20 Published:2020-08-28

Abstract

Abstract: Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.

Key words: Thrombolysis, Retinal artery occlusion/therapy, Arterial thrombolysis, Intravenous thrombolysis

CLC Number:

R765.21

Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.. Application progress of thrombolysis in retinal artery occlusionYANG Ming Overview WEI Wenbin Guidance Beijing Tongren Hospital, Capital Medical University / Beijing Tongren Eye Center / Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment / Beijing Ophthalmology&Visual Sciences Key Lab / Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing 100730, ChinaAbstract:[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 5-10.

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