高压氧治疗COVID-19后视神经炎1例及文献分析

doi:10.6040/j.issn.1673-3770.0.2023.277

摘要/Abstract

摘要： 目的为新型冠状病毒肺炎感染后视神经炎的早期视力挽救提供新的临床治疗方法和策略。方法回顾性分析3例COVID-19感染后视神经炎患者的临床资料并复习相关文献。结果 COVID-19感染无论是在急性期还是在随后的恢复期都会对感染患者视网膜和视神经产生影响,本研究的3例病例常规药物治疗后视力恢复较差,其中1例接受联合高压氧治疗后视力恢复明显、近期与远期视力恢复程度完全。结论 COVID-19感染后视神经炎并不罕见,及时早期联合高压氧干预治疗COVID-19感染后视神经炎疗效更快、更优,对此类患者尽快恢复视力、防止不可逆转的视力丧失具有重要意义,值得临床重视和推广。

关键词: 新型冠状病毒肺炎, 视神经炎, 高压氧, 视力, 激素

Abstract: Objective This study aims to provide a new clinical treatment method and strategy for early vision rescue of optic neuritis after COVID-19 infection. Methods The clinical data of three patients with optic neuritis after COVID-19 infection were retrospectively analyzed, and the related literature was reviewed. Results COVID-19 infection affects the retina and optic nerve of patients in the acute and subsequent recovery stages. In this study, three patients demonstrated poor vision recovery after conventional drug treatment. Among them, one patient received combined hyperbaric oxygen therapy, the vision recovery was significantly faster, and the short- and long-term vision recovery was complete. Conclusion Optic neuritis after COVID-19 infection is common. Enhancing early vision rescue with hyperbaric oxygen intervention in the treatment of optic neuritis after COVID-19 infection is an effective and better approach. Immediate vision restoration and prevention of irreversible vision loss in these patients, carry immense clinical significance and merit promotion.

Key words: COVID-19, Optic neuritis, Hyperbaric oxygen, Vision, Hormone

中图分类号:

R563.1

王磊,王学艺,田艳娟,匡爱华,段小妮,赵寅. 高压氧治疗COVID-19后视神经炎1例及文献分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 100-104.

WANG Lei, WANG Xueyi, TIAN Yanjuan, KUANG Aihua, DUAN Xiaoni, ZHAO Yin. Hyperbaric oxygen therapy for optic neuritis after COVID-19: a case report and literature analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 100-104.

参考文献

[1] World Health Organization.Drugs to prevent COVID-19: living guideline[DB/OL].[2023-5-21].https://www.who.int/publications/i/item/WHO-2019-nCoV-prophylaxes-2023.1
[2] Ballering A, van Zon SV, Olde Hartman TO, et al. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study[J]. Lancet Lond Engl, 2022, 400: 452-461. doi:10.1016/S0140-6736(22)01214-4
[3] Zawilska JB, Kuczyńska K. Psychiatric and neurological complications of long COVID[J]. J Psychiatr Res, 2022, 156: 349-360. doi:10.1016/j.jpsychires.2022.10.045
[4] Soriano JB, Murthy S, Marshall JC, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus[J]. Lancet Infect Dis, 2022, 22(4): e102-e107. doi:10.1016/S1473-3099(21)00703-9
[5] Cevallos MAV, Vásquez AM. Alteraciones en el nervio óptico y retina en pacientes con COVID-19, Una revisión teórica [J]. Arch Soc Esp Oftalmol, 2023. doi:10.1016/j.oftal.2023.06.002
[6] Sen M, Honavar SG, Sharma N, et al. COVID-19 and eye: a review of ophthalmic manifestations of COVID-19[J]. Indian J Ophthalmol, 2021, 69(3): 488-509. doi:10.4103/ijo.IJO_297_21
[7] Duran M, Aykaç S. Optic neuritis after COVID-19 infection: a case report[J]. J Francais D'ophtalmologie, 2022, 46: 4-7. doi:10.1016/j.jfo.2022.09.005
[8] Ally N, Alli HD, Jeeva-Patel T, et al. Optic neuritis: a South African hospital-based prospective study protocol[J]. PLoS ONE, 2022, 17(6):0269514. doi:10.1371/journal.pone.0269514
[9] 中华医学会眼科学分会神经眼科学组. 视神经炎诊断和治疗专家共识(2014年)[J]. 中华眼科杂志, 2014(6): 459-463. doi: 10.3760/cma.j.issn.0412-4081.2014.06.013
[10] Azab MA, Hasaneen SF, Hanifa H, et al. Optic neuritis post-COVID-19 infection. a case report with meta-analysis[J]. Interdiscip Neurosurg. 2021, 26(10):101320. doi: 10.1016/j.inat.2021.101320
[11] Sainath D, Paul A, Krishnagopal S, et al. Acute bilateral retrobulbar optic neuritis - An atypical sequela of COVID-19[J]. Indian J Ophthalmol, 2021, 69(12):3761-3764. doi: 10.4103/ijo.IJO_2155_21
[12] Jossy A, Jacob N, Sarkar S, et al. COVID-19-associated optic neuritis - A case series and review of literature[J]. Indian J Ophthalmol, 2022, 70(1): 310-316. doi:10.4103/ijo.IJO_2235_21
[13] Sawalha K, Adeodokun S, Kamoga GR. COVID-19-induced acute bilateral optic neuritis[J]. J Investig Med High Impact Case Rep, 2020, 8:2324709620976018. doi: 10.1177/2324709620976018
[14] Zhou SW, Jones-López E, Soneji D, et al. Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis and myelitis in COVID-19[J]. 2020, 40(3):398-402. doi: 10.1097/WNO.0000000000001049
[15] Kogure C, Kikushima W, Fukuda Y, et al. Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis in a COVID-19 patient: a case report[J]. Medicine, 2021, 100(19): 25865. doi:10.1097/MD.0000000000025865
[16] Gold DM, Galetta SL. Neuro-ophthalmologic complications of coronavirus disease 2019(COVID-19)[J]. Neurosci Lett, 2021, 742: 135531. doi:10.1016/j.neulet.2020.135531
[17] Abdul-Salam State SE, Sfredel V, Mocanu CL, et al. Optic neuropathies post-Covid 19-review[J]. Romanian Journal of Ophthalmology, 2022, 66(4): 289-298. doi:10.22336/rjo.2022.54
[18] Shapira R, Solomon B, Efrati S, et al. Hyperbaric oxygen therapy ameliorates pathophysiology of 3xTg-AD mouse model by attenuating neuroinflammation[J]. Neurobiol Aging, 2018, 62: 105-119. doi:10.1016/j.neurobiolaging.2017.10.007
[19] Benson RM, Minter LM, Osborne BA, et al. Hyperbaric oxygen inhibits stimulus-induced proinflammatory cytokine synthesis by human blood-derived monocyte-macrophages[J]. Clin Exp Immunol, 2003, 134(1): 57-62. doi:10.1046/j.1365-2249.2003.02248.x
[20] Gottfried I, Schottlender N, Ashery U. Hyperbaric oxygen treatment-from mechanisms to cognitive improvement[J]. Biomolecules, 2021, 11(10): 1520. doi:10.3390/biom11101520
[21] Shai E, Eshel BJ. Reflections on the neurotherapeutic effects of hyperbaric oxygen[J]. Expert Rev Neurother, 2014, 14(3): 233-236. doi:10.1586/14737175.2014.884928
[22] 曹锦泉, 张绪中. 高压氧—二氧化碳混合气治疗急性视神经炎31例的疗效[J]. 中华航海医学杂志, 1995(3): 54-55. doi: 10.3760/cma.j.issn.1005-3506.1995.03.126
[23] 高承兰, 毕竹梅. 高压氧治疗急性视神经炎的疗效观察[J]. 山东大学基础医学院学报, 2002, 16(4):230-231. doi: 10.3969/j.issn.1673-3770.2002.04.018 GAO Chenglan, BI Zhumei. Hyperbaric oxygenation on acute optic neuritis[J]. Journal of Preclinical Medicine College of Shandong Medical University, 2002, 16(4):230-231. doi: 10.3969/j.issn.1673-3770.2002.04.018
[24] 刘秀明, 王曙红, 王文奇. 高压氧联合复方樟柳碱治疗急性视神经炎疗效观察[J]. 海南医学, 2013, 24(9):1367-1368. doi: 10.3969/j.issn.1003-6350.2013.09.0575 LIU Xiuming, WANG Shuhong, WANG Wenqi. Clinical effect of hyperbaric oxygen combined with compound anisodine in the treatment of acute optic neuritis[J]. Hainan Medical Journal, 2013, 24(9):1367-1368. doi: 10.3969/j.issn.1003-6350.2013.09.0575
[25] 张志广, 朱海清. 高压氧二氧化碳混合气在急性视神经炎临床治疗中的效果[J]. 中国实用神经疾病杂志, 2015(22): 7-8. doi:10.3969/j.issn.1673-5110.2015.22.004 ZHANG Zhiguang, ZHU Haiqing. Clinical application effect of hyperbaric oxygen and carbon dioxide mixture in the treatment of acute optic neuritis[J]. Chinese Journal of Practical Nervous Diseases, 2015(22): 7-8. doi:10.3969/j.issn.1673-5110.2015.22.004

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