ISSN 1673-3770 CN 37-1437/R
Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (4): 48-52.doi: 10.6040/j.issn.1673-3770.1.2020.045
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By analyzing the treatment process of a clinical case of ocular ischemic syndrome, the clinical significance of combined therapy in the treatment of ocular ischemic syndrome was discussed.眼缺血综合征(ocular ischemic syndrome, OIS)是由颈动脉阻塞或狭窄所致脑和眼的供血不足, 动脉灌注压过低而引起的眼前后节缺血病征, 属于一种慢性缺血性疾病［1］。由于该病临床表现多样, 常见漏诊和误诊, 从而导致严重后果［2-3］。Hedges于1963年在一位左侧颈内动脉完全阻塞的患者眼底中发现视网膜血管扩张和周围点状出血的现象［4］。同年, 另有两位学者报道称约5%的“静脉淤滞性视网膜病变”患者伴有单侧颈动脉狭窄或闭塞［5］。近年来, 随着眼科医生对此类眼病认识的不断提升, 这些可能由于颈动脉狭窄或闭塞引起的眼部疾病逐渐被统称为“眼缺血综合征”［6］。目前国内针对OIS的多学科系统研究并不多见, 大多数报道均来自眼科医师, 表明本病临床认识尚不足够。现将1 例OIS患者的诊疗资料报告如下, 并结合文献资料进行讨论。
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| [1] | ObjectiveTo compare the effects of intra-arterial thrombolysis and traditional treatment in central retinal artery occlusion(CRAO). MethodsWe searched the Pubmed, Embase, Clinical.gov, CNKI, and Wan Fang databases for related studies that were published up to May , . We included clinical controls that compared intra-arterial thrombolysis and conventional treatment in CRAO. The random effect model and R software were used for data analysis. ResultsWe identified seven studies including CRAO patients. Meta-analysis results of two randomized controlled trials(RCTs)showed that there was no significant difference in visual acuity improvement between CRAO patients treated with arterial thrombolysis therapy and those with conventional therapy(RR: ., % confidence interval .-., P=.). Meta-analysis results of five cohort studies indicated that compared with conventional therapy, arterial thrombolysis therapy significantly improved visual acuity(RR: ., % confidence interval .-., P<.). The difference between thrombolysis therapy and conventional therapy may be caused by the different treatment time windows in patients. Concerning the adverse reactions after treatment, two RCTs and five cohort studies showed that the adverse reactions in the thrombolysis group are significantly higher than those in the conventional treatment group. ConclusionAlthough intra-arterial thrombolysis therapy has therapeutic potential in CRAO patients, there is still insufficient clinical evidence to prove its effectiveness and safety. Further studies with a large sample and high quality RCTs are required.. Intra-arterial thrombolysis for central retinal artery occlusion: a Meta-analysisCHEN Xi, LI Shanshan, ZHAO Lu, YOU Ran, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 28-34. |
| [2] | ObjectiveObjectiveTo analyze the literature on ocular ischemic syndrome published between January , and December , . MethodPapers on OIS that were published between January , and December , , were screened and retrieved from the CNKI and WOS databases, and those that were relevant were searched and analyzed. ResultsIn this analysis, Chinese papers on OIS were cited for times with an h-index of , while foreign papers were cited for times with an h-index of . Of the organizations that published the highest number of papers and had the highest h-indexes, the Capital Medical University and the Polish Medical University of Pomerania were the leading institutions. The Chinese Journal of Ophthalmology was the leading domestic journal, and the Journal of Ophthalmology and Plos One were the leading foreign journals. China published the highest number of papers abroad, China and South Korea had the highest h-indexes. China′s National Natural Science Foundation provided the most support to the field of OIS, accounting for .% of the total domestic literature. The most frequently cited article in the WOS database was by Hayreh, SS, which was on the prevalence and pathogenesis of ocular vascular occlusive disease and melanosis, it was also part of the top ten studies that focused on the utility of OCT in providing insights into OIS and the mechanisms of ischemia and hypoxia. ConclusionThe utility of OCT in providing insights into OIS and the mechanisms of hypoxia and ischemia represents a modern focus of researchers.. Analysis of the literature on ocular ischemic syndrome at home and abroadMENG Bo, HUANG Yingxiang, WANG Kang, ZHAO Lu, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 35-40. |
| [3] | ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.. Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue1, WANG Haiwei2, LI Wensi1, YANG Xintong1, SUN Cun1, ZHAO Yuan1, ZHAO Pengbo1, ZHANG Jianqiang1 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 64-68. |
| [4] | To evaluate the changes in the parameters of the macular and peripapillary vasculature in patients with neuromyelitis optica spectrum disorder(NMOSD). MethodsThis case-control study involved 40(76 eyes)aquaporin-4 antibody-positive NMOSD patients and 40(80 eyes)age- and gender-matched healthy controls(HCs). Of 76 eyes with NMOSD, 34 had a history of optic neuritis(ON); 40 had no history of ON. Macular superficial vessel density(MSVD), macular deep vessel density(MDVD), and radial peripapillary capillary(RPC)density were measured by OCT-A. The retinal nerve fiber layer(RNFL)and ganglion cell complex(GCC)thicknesses were measured by OCT. Comparisons of the retinal structural and microvascular parameters of the cohorts were performed using generalized estimating equation(GEE)models. The relationship between retinal vessel density and retinal thickness was also analyzed. ResultsRPC density and MSVD were significantly lower in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.05). The GCC and RNFL thicknesses were also significantly thinner in eyes with NMOSD+ON than in those with NMOSD-ON and HC(P<0.001 for both). MDVD was lower in eyes with NMOSD-ON than in those with HC(P<0.05); however, other vessel densities were not significantly different(P>0.05). In eyes with NMOSD, MSVD, whole image vessel density(WIVD)of RPC, and peripapillary vessel density(PPVD)were correlated with GCC and RNFL thicknesses(P<0.001). However, MDVD and inside disc vessel density(IDVD)were not correlated with GCC and RNFL thicknesses(P>0.05). ConclusionRetinal microvascular changes were present in eyes with NMOSD+ON. However, these changes, except those in MDVD, were not significant in eyes with NMOSD-ON. Thinner GCC and RNFL were associated with lower MSVD and RPC density.. Measurement of the parameters of the macular retinal and peripapillary vasculature in neuromyelitis optica spectrum disorder patientsXU Jing, QU Yuanzhen, LIANG Xiaofang, YANG Liu, TANG Yang Department of Ophthalmology,Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaAbstract: Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 69-74. |
| [5] | To describe characteristics and risk factors associated with central serous chorioretinopathy(CSC)in a hospital-based outpatient sample population. MethodsIn this hospital-based cross-sectional study, CSC patients were recruited from the Beijing Friendship Hospital from 01/2019 to 12/2019. All participants underwent a standardized interview. Logistic regression models were used to assess the risk factors associated with CSC. ResultsA total of 23,878 outpatients were recorded during the period 01/2019-12/2019. Of these, 45 patients(0.19%)were diagnosed with CSC, divided in 37 male patients(82.22%)and 8 female patients(17.78%). The patients′ age ranged from 21 to 65(42.3±10.1)years. Three patients(6.67%)presented a bilateral involvement. Of all the patients, 39 were included in the present analysis. Control patients were matched for age and sex at a ratio of 1:1. The presence of CSC was associated with exposure to steroids(OR=5.04, 95% CI:1.11-22.89), sleep time(going to sleep after 12 pm)(OR=4.16, 95% CI:1.33-13.04)),and shift-work(OR=5.74, 95% CI:1.47-22.45).ConclusionsOur data showed that CSC prevalence in the analyzed outpatients was 0.19%. Exposure to steroids, sleep time, and shift-work were factors related with CSC in the observed population.. Prevalence and risk factors of central serous chorioretinopathy in a hospital-based population YANG Xiufen, YOU Ran, MA Xiumei, WANG Kang, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 75-79. |
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