急性视网膜动脉缺血的防治研究进展

Advances in the treatment and prevention of acute retinal arterial ischemia

急性短暂性或永久性视网膜动脉缺血是需要及时诊断和治疗的眼部和全身急症。单眼一过性黑矇属于短暂性视网膜动脉缺血,并不会遗留永久性视功能损害。视网膜中央动脉阻塞和视网膜分支动脉阻塞在大部分患者均会遗留永久性视功能损害。目前的治疗方式包括降眼压、扩血管、高压氧、经静脉或动脉溶栓治疗等,但仍缺乏标准治疗方案。对高危人群应早期一级预防。急性视网膜动脉缺血患者发生继发卒中和不良心血管事件的风险高,应及时发现相关危险因素,积极治疗原发病,采取适当的二级预防措施改善预后。本文对急性视网膜动脉缺血事件的治疗和预防研究进展进行综述,以便为该类疾病的防治和研究提供参考。

Acute transient or permanent retinal arterial ischemia is ocular and systemic emergency requiring immediate diagnosis and treatment.Transient monocular vision loss is transient retinal arterial ischemia which leaves no permanent deficits.Central retinal arterial occlusion and branch retinal arterial occlusion lead to permanent visual function deficits in the majority of patients.Current treatment include lowering intraocular pressure,dilating blood vessels,hyperbaric oxygen therapy,intravenous or intra-arterial thrombolysis and so on,but there is still no standard treatment procedure.High risk groups should receive primary prevention measures in order to reduce the incidence of the disease.Patients with acute retinal arterial ischemia are at high risk of subsequent stroke and adverse cardiovascular events.Relevant risk factors should be identified in time,the primary disease should be treated actively,and appropriate secondary prevention measures should be taken to improve the prognosis.This review summarizes the recent treatment and prevention procedures of acute retinal arterial ischemia,to provide references for the management of these diseases.