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Venkatesh R, Joshi A, Maltsev D, Munk M, Prabhu V, Bavaskar S, Mangla R, Ruamviboonsuk P, Chhablani J. Update on central retinal artery occlusion. Indian J Ophthalmol 2024; 72:945-955. [PMID: 38905460 DOI: 10.4103/ijo.ijo_2826_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/13/2024] [Indexed: 06/23/2024] Open
Abstract
The medical condition referred to as "central retinal artery occlusion" (CRAO) was first documented by Albrecht von Graefe in 1859. Subsequently, CRAO has consistently been identified as a serious medical condition that leads to substantial visual impairment. Furthermore, it is correlated with vascular complications that have the potential to affect crucial organs such as the brain and heart. A considerable amount of research has been extensively published on the various aspects of this topic, which is marked by notable debates and misconceptions, especially regarding its management and outcomes. The primary aim of this review article is to analyze the latest developments in the understanding of CRAO, which includes its causes, techniques for retinal imaging, systemic evaluation, and therapeutic strategies, such as vitrectomy. This review article offers readers a comprehensive learning experience to gain knowledge on the fundamental principles and recent advancements in CRAO.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Vitreo-retinal Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Aishwarya Joshi
- Department of Vitreo-retinal Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Dmitrii Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia
| | - Marion Munk
- Department of Retina, Augenarzt Praxisgemeinschaft Gutblick AG, Pfäffikon, Switerland
- Department of Retina, University Hospital Bern, Inselspital, Bern, Switzerland
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Vishma Prabhu
- Department of Vitreo-retinal Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Snehal Bavaskar
- Department of Vitreo-retinal Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Rubble Mangla
- Department of Vitreo-retinal Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Paisan Ruamviboonsuk
- Department of Ophthalmology, College of Medicine, Rangsit University, Lak Hok, Thailand
- Center of Excellence for Vitreous and Retinal Disease, Rajavithi Hospital, Bangkok, Thailand
| | - Jay Chhablani
- Department of Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA 15213, USA
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Daxer B, Radner W, Fischer F, Cocoșilă AL, Ettl A. Aetiology, Diagnosis and Treatment of Arterial Occlusions of the Retina-A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:526. [PMID: 38674172 PMCID: PMC11052062 DOI: 10.3390/medicina60040526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
Arterial occlusions of the retina are potentially sight-threatening diseases which often result in profound visual loss. The aim of this narrative review is to provide an overview of the aetiology, discuss major risk factors, describe the management and systemic assessments and evaluate existing therapies. For this review, an extensive literature search in PubMed was performed. Emboli from the heart or the carotid arteries can cause ophthalmic artery occlusion (OAO), central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). Most patients with arterial occlusions have vascular risk factors such as arterial hypertension, hyperhomocysteinaemia, carotid stenosis and atrial fibrillation, which also increase the risk of cerebral stroke and myocardial infarction. Therapies such as ocular massage, thrombolysis and anterior chamber paracentesis have been suggested but are still equivocal. However, it is evident that retinal artery occlusion should be immediately treated and accompanied by interdisciplinary collaboration, since early diagnosis and the proper treatment of possible risk factors are important to reduce the risk of further damage, recurrences, other vascular diseases and mortality.
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Affiliation(s)
- Barbara Daxer
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Department of Ophthalmology and Orbital Surgery, University Hospital St. Pölten, Dunantplatz 1, 3100 St. Pölten, Austria
| | - Wolfgang Radner
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Department of Ophthalmology and Orbital Surgery, University Hospital St. Pölten, Dunantplatz 1, 3100 St. Pölten, Austria
- Austrian Academy of Ophthalmology, Mollgasse 11, 1180 Vienna, Austria
| | - Florian Fischer
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Department of Ophthalmology and Orbital Surgery, University Hospital St. Pölten, Dunantplatz 1, 3100 St. Pölten, Austria
| | - Andreea-Liliana Cocoșilă
- Faculty of Medicine and Pharmacy, University of Oradea, 1 Decembrie Square 10, 410068 Oradea, Romania
| | - Armin Ettl
- Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Department of Ophthalmology and Orbital Surgery, University Hospital St. Pölten, Dunantplatz 1, 3100 St. Pölten, Austria
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Madero J, Salvador M, Kadouch J, Muñoz-Gonzalez C, Fakih-Gomez N. Role of Hyperbaric Oxygen in Filler-Induced Vascular Occlusion. Aesthetic Plast Surg 2024:10.1007/s00266-024-03920-7. [PMID: 38459381 DOI: 10.1007/s00266-024-03920-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
INTRODUCTION The rising incidence of filler-induced vascular complications in the context of aesthetic procedures necessitates a thorough assessment of therapeutic options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential intervention for filler-induced vascular occlusion (FIVO), although optimal dosing and timing remain undefined. METHODS This review explores the pathophysiology of FIVO and elucidates HBOT's multifaceted role in salvaging ischemic tissue. The physical and biochemical mechanisms of HBOT, including its vasodilatory, anti-spasmodic, and anti-inflammatory effects, are examined. RESULTS HBOT serves as an adjunctive therapy in FIVO management, emphasizing timely intervention, adherence to specific pressures (two atmosphere absolute), and session durations (60 minutes) to optimize efficacy and minimize complications. While existing HBOT protocols for compromised grafts provide insights, standardized guidelines for FIVO are lacking. CONCLUSION HBOT enhances tissue oxygenation, modulates reactive oxygen species, and influences angiogenesis and hypoxia response. However, it does not replace key treatment protocols for filler vascular complications. Further research and standardized protocols are warranted to define HBOT's definitive role in mitigating filler-induced vascular complications. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Javier Madero
- Critical Care Unit, Provincial Hospital of Castellon, Castellón de la Plana, Spain
| | - Manolo Salvador
- Hyperbaric Therapy Unit, General Hospital of Castellon, Castellón de la Plana, Spain
| | - Jonathan Kadouch
- Practice for Aesthetic Dermatology, ReSculpt Clinic, Amsterdam, The Netherlands
| | - Cristina Muñoz-Gonzalez
- Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Main Street Khaizaran, Saida, Lebanon
| | - Nabil Fakih-Gomez
- Department of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Main Street Khaizaran, Saida, Lebanon.
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Tiwari V, Bagga SSJ, Prasad R, Mathurkar S. A Review of Current Literature on Central Retinal Artery Occlusion: Its Pathogenesis, Clinical Management, and Treatment. Cureus 2024; 16:e55814. [PMID: 38590501 PMCID: PMC10999893 DOI: 10.7759/cureus.55814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
The ocular analogue of a cerebral stroke is central retinal artery occlusion (CRAO), a medical emergency concerning the eyes. Most patients experience substantial acute vision loss with a visual acuity of 20/400 or worse, resulting in decreased quality of life (QoL) and decreased functional ability. An impending cerebral stroke and ischemic heart disease are also more likely. The four distinct clinical entities that make up CRAO are non-arteritic CRAO, transitory non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, and arteritic CRAO. Depending on the CRAO type, clinical traits, visual results, and treatment all vary greatly. Contrary to current belief, there is a spontaneous improvement in the optical field and vision, mainly in the first week. The likelihood of instinctive development in optical acuity in the first seven days varies greatly. The pathogenesis, epidemiology, and medical features of CRAO will be described in this review, along with present and potential management future options.
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Affiliation(s)
- Varun Tiwari
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Simerjeet Singh J Bagga
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapneel Mathurkar
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Cetinoglu I, Unlu MT, Sit HY, Aygun N, Tiryaki Demir S, Uludag M. A unique complication of thyroidectomy for Hashimoto's thyroiditis: central retinal artery thrombosis. Acta Chir Belg 2024:1-6. [PMID: 38391299 DOI: 10.1080/00015458.2024.2323286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/22/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Central retinal artery occlusion (CRAO) is a rare ophthalmological emergency and also a unique complication after thyroid surgery. METHODS We present the first case of CRAO following thyroid surgery in a patient with Hashimoto's thyroiditis, along with a variety of interventions to overcome this complication. RESULTS A 42-year-old female patient suffering from sudden vision loss following total thyroidectomy was diagnosed with CRAO. Hyperbaric oxygen therapy was started within the postoperative first 6 hours. CONCLUSION Although it is extremely rare, it should be noted that patients may experience retinal artery occlusion following the thyroid surgery. Immediate evaluation of patients with visual impairment in the early postoperative period, and planning of emergent hyperbaric oxygen therapy for the management are critical.
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Affiliation(s)
- Isik Cetinoglu
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Mehmet Taner Unlu
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Hatice Yasemin Sit
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Nurcihan Aygun
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Semra Tiryaki Demir
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Mehmet Uludag
- Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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Larochelle RD, Koduri V, Chen R, Subramanian PS. Reply to Comment on Embolic Abducens Palsy and Central Retinal Artery Occlusion (CRAO) in a Patient With COVID-19: Response. J Neuroophthalmol 2023; 43:e359-e360. [PMID: 35421044 DOI: 10.1097/wno.0000000000001552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ryan D Larochelle
- Sue Anschutz-Rodgers UCHealth Eye Center and Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, Sue Anschutz-Rodgers UCHealth Eye Center and Departments of Ophthalmology, Neurology, and, Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado; and Division of Ophthalmology, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Driban M, Kedia N, Arora S, Chhablani J. Novel pharmaceuticals for the management of retinal vein occlusion and linked disorders. Expert Rev Clin Pharmacol 2023; 16:1125-1139. [PMID: 37933706 DOI: 10.1080/17512433.2023.2277882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Retinal vein occlusion (RVO) is the second leading cause of blindness from retinal vascular disease behind diabetic retinopathy. Anti-vascular endothelial growth factor (VEGF) and glucocorticoid therapy are the cornerstones of pharmaceutical treatment for RVO. There is considerable interest in developing new pharmaceuticals in and out of these two classes to reduce costs, lower injection burden, and treat the occlusion itself, rather than the complications. AREAS COVERED In this review, we discuss novel pharmaceuticals for the treatment of RVO outside of current standard of care. We performed a comprehensive literature search encompassing pharmaceuticals that have recently been approved or have shown promising results in early clinical trials or animal models. EXPERT OPINION Anti-VEGF therapy remains the most efficacious treatment for RVO with a very favorable side effect profile. New biosimilars reduce costs while maintaining efficacy. Novel glucocorticoids may be a useful therapy in patients for whom anti-VEGF therapy has failed, or as an adjunct. Pharmaceuticals in other drug classes, particularly those with neuroprotective or regenerative properties, as well as those geared toward treating the occlusion itself, represent exciting options for early RVO therapy, but are likely years away from clinical relevance.
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Affiliation(s)
- Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nikita Kedia
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Supriya Arora
- Bahamas Vision Center and Princess Margaret Hospital, Nassau, New Providence, Bahamas
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Okonkwo ON, Agweye CT, Akanbi T. Neuroprotection for Nonarteritic Central Retinal Artery Occlusion: Lessons from Acute Ischemic Stroke. Clin Ophthalmol 2023; 17:1531-1543. [PMID: 37284058 PMCID: PMC10239763 DOI: 10.2147/opth.s403433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
Nonarteritic central retinal artery occlusion (NA-CRAO) is a variant of acute ischemic stroke (AIS) and is a cause of sudden severe loss of vision. There are guidelines by the American Heart Association and the American Stroke Association for the care of CRAO patients. This review explores the basis of retinal neuroprotection for CRAO and its potential for improving the outcome of NA-CRAO. Recently, there have been significant advances in research into the use of neuroprotection to treat retinal diseases, including retinal detachment, age-related macular degeneration, and inherited retinal diseases. Also, neuroprotective research in AIS has been extensive, and newer drugs tested, including Uric acid, Nerinetide, and Otaplimastat, with promising results. Progress in cerebral neuroprotection after AIS offers hope for retinal neuroprotection after CRAO; and a possibility of extrapolating research findings from AIS into CRAO. Combining neuroprotection and thrombolysis can extend the therapeutic window for NA-CRAO treatment and potentially improve outcomes. Experimented neuroprotection for CRAO includes Angiopoietin (Comp Ang1), KUS 121, Gene therapy (XIAP), and hypothermia. Efforts in the field of neuroprotection for NA-CRAO should focus on better imaging to delineate the penumbra after an acute episode of NA-CRAO (using a combination of high-definition optical coherence angiography and electrophysiology). Also, research should explore details of pathophysiologic mechanisms involved in NA-CRAO, allowing for further neuroprotective intervention, and closing the gap between preclinical and clinical neuroprotection.
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Affiliation(s)
- Ogugua Ndubuisi Okonkwo
- Department of Ophthalmology, Eye Foundation Hospital and Eye Foundation Retina Institute, Ikeja, Lagos, Nigeria
| | - Chineze Thelma Agweye
- Department of Ophthalmology, University of Calabar and University of Calabar Teaching Hospital, Cross River, Nigeria
| | - Toyin Akanbi
- Department of Ophthalmology, Eye Foundation Hospital and Eye Foundation Retina Institute, Ikeja, Lagos, Nigeria
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Lee CT, Hsieh TH, Chu CC, Hsu YR, Wang JH, Wang JK, Zhao Z, Chang HT. Hyperbaric oxygen therapy as rescue therapy for pediatric frosted branch angiitis with Purtscher-like retinopathy: A case report. Front Med (Lausanne) 2023; 10:1119623. [PMID: 37138735 PMCID: PMC10149671 DOI: 10.3389/fmed.2023.1119623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Frosted branch angiitis (FBA) is an uncommon uveitis characterized by fulminant retinal vasculitis. Purtscher-like retinopathy (PuR) is a rare retinal angiopathy associated with a non-traumatic etiology. Both FBA and PuR can cause profound visual impairments. Case report We describe the case of a 10-year-old male who presented with sudden bilateral painless visual loss due to FBA with concurrent PuR, with notable viral prodrome 1 month prior to presentation. Systemic investigations revealed a recent herpes simplex virus 2 infection with a high titer of IgM, positive antinuclear antibody (ANA) (1:640), and abnormal liver function tests. After administration of systemic corticosteroids, anti-viral agents, and subsequent immunosuppressive medications, the FBA was gradually alleviated. However, fundoscopy and optical coherence tomography (OCT) revealed persistent PuR and macular ischemia. Hence, hyperbaric oxygen therapy was administered as a rescue strategy, which resulted in gradual bilateral visual acuity improvement. Conclusion Hyperbaric oxygen therapy may be a beneficial rescue treatment for retinal ischemia secondary to FBA with PuR.
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Affiliation(s)
- Chi-Tai Lee
- Center of Hyperbaric Oxygen, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Chest Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tzu-Han Hsieh
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chan-Ching Chu
- Center of Hyperbaric Oxygen, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Chest Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yung-Ray Hsu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Jia-Horng Wang
- Department of Critical Care Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Zhanqi Zhao
- Department of Biomedical Engineering, Fourth Military Medical University, Xi’an, China
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - Hou-Tai Chang
- Center of Hyperbaric Oxygen, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Critical Care Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Industrial Engineering and Management, Yuan Ze University, Taoyuan, Taiwan
- *Correspondence: Hou-Tai Chang,
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[Retinal arterial occlusions (RAV) : S2e guidelines of the German Society of Ophthalmology (DOG), the German Retina Society (RG) and the German Professional Association of Ophthalmologists (BVA). Version: 7 October 2022]. DIE OPHTHALMOLOGIE 2023; 120:15-29. [PMID: 36525048 DOI: 10.1007/s00347-022-01780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 12/23/2022]
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Yan Y, Zhang X, An X, Fan W, Liang J, Luo B, Ren H, Huang Y. The application and perspective of hyperbaric oxygen therapy in acute ischemic stroke: From the bench to a starter? Front Neurol 2022; 13:928802. [PMID: 35989933 PMCID: PMC9389005 DOI: 10.3389/fneur.2022.928802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Stroke has become a significant cause of death and disability globally. Along with the transition of the world's aging population, the incidence of acute ischemic stroke is increasing year by year. Even with effective treatment modalities, patients are not guaranteed to have a good prognosis. The treatment model combining intravenous thrombolysis/endovascular therapy and neuroprotection is gradually being recognized. After the clinical translation of pharmacological neuroprotective agents failed, non-pharmacological physical neuroprotective agents have rekindled hope. We performed a literature review using the National Center for Biotechnology Information (NCBI) PubMed database for studies that focused on the application of hyperbaric oxygen therapy in acute ischemic stroke. In this review, we present the history and mechanisms of hyperbaric oxygen therapy, focusing on the current status, outcomes, current challenges, perspective, safety, and complications of the application of hyperbaric oxygen in animal experiments and human clinical trials. Hyperbaric oxygen therapy, a non-pharmacological treatment, can improve the oxygenation level at the ischemic lesions in increased dissolved oxygen and oxygen diffusion radius to achieve salvage of neurological function, giving a new meaning to acute ischemic stroke.
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Affiliation(s)
- Yujia Yan
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China
| | - Xiqiang Zhang
- Department of Neurosurgery, Third People's Hospital of Xining City, Xining, China
| | - Xingwei An
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Center for Brain Science, Tianjin, China
| | - Wanpeng Fan
- Department of Neurosurgery, Third People's Hospital of Xining City, Xining, China
| | - Jingbo Liang
- Department of Neurosurgery, Third People's Hospital of Xining City, Xining, China
| | - Bin Luo
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China
| | - Hecheng Ren
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China
- *Correspondence: Hecheng Ren
| | - Ying Huang
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China
- Ying Huang
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Wang LU, Chen FT, Wang JK, Huang TL, Chang PY, Chen YJ, Hsu YR. Ocular inflammatory manifestations following COVID-19 vaccinations in Taiwan: A case series. Taiwan J Ophthalmol 2022; 12:465-471. [PMID: 36660122 PMCID: PMC9843569 DOI: 10.4103/2211-5056.353129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/12/2022] [Indexed: 01/22/2023] Open
Abstract
As a continuing demand for booster shots against SARS-CoV-2, ocular adverse events following the coronavirus disease-2019 (COVID-19) vaccines can cause significant visual impairment, and they warrant a high awareness and detailed documentation of possible ocular inflammatory manifestations. We present a case series of 11 patients presenting with ocular manifestations relevant to vaccine-associated autoimmune response within 6 weeks after the vaccination of the Oxford-AstraZeneca, the Moderna, and Pfizer-BioNTech vaccines at the main tertiary referral center in the most populated and most vaccinated city in Taiwan. Their diagnosis included five acute anterior uveitis, two multiple evanescent white dot syndrome, one probable Vogt-Koyanagi-Harada disease, one anterior scleritis, one relapsed idiopathic panuveitis, and one autoantibody-related central retinal artery occlusion. This report presented a broad spectrum of the ocular inflammatory events following the vaccination of COVID-19. Early recognition of the clinical manifestations mentioned herein with prompt management is crucial in recovering the patients' vision.
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Affiliation(s)
- Ling-Uei Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Fang-Ting Chen
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan,Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Tzu-Lun Huang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Pei-Yao Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Ju Chen
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan,Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Ray Hsu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan,Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan,Address for correspondence: Dr. Yung-Ray Hsu, Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banciao, New Taipei City 220, Taiwan. E-mail:
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Muacevic A, Adler JR. Central Retinal Artery Occlusion: Can We Effectively Manage This Ocular Emergency in a Hospital Setting? Cureus 2022; 14:e27840. [PMID: 36106224 PMCID: PMC9459408 DOI: 10.7759/cureus.27840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/05/2022] Open
Abstract
Central retinal artery occlusion (CRAO) is an ophthalmological emergency characterized by partial or complete occlusion of the central retinal artery. It is the ocular equivalent of an ischemic cerebral stroke. Patients frequently present with a significant, abrupt, painless loss of vision in one eye, with only around 20% of those affected getting functional visual acuity restored in the affected eye. Despite more than 150 years of clinical research, no consensus has been achieved regarding the most effective method of treating CRAO. The efficacy of all proposed treatments is debatable, and many of them have ambiguous risk profiles that present particular diagnostic and management difficulties and cause variations in clinical practice. In certain circumstances, thrombolysis may be attempted as a treatment option. However, the evidence to support the general use of thrombolytics in treating acute CRAO remains elusive. It is known that the risk factors predisposing to other cardiovascular and cerebrovascular events are often present in CRAO. Accordingly, identifying patients at the highest risk of stroke and secondary prevention of ischemic events remains the primary focus of management. This review offers a summary of all the current treatment options available for managing CRAO, with particular reference to their limitations and inconsistent results found in relevant studies until 2022.
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Huang NC, Wu YL, Chao RF. Visualization and Bibliometric Analysis of Research Trends on Hyperbaric Oxygen Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137866. [PMID: 35805526 PMCID: PMC9265454 DOI: 10.3390/ijerph19137866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
Hyperbaric oxygen therapy (HBOT) is a professional medical regimen with a wide range of clinical applications in various research fields. In addition to treating diving decompression sickness and air embolism, HBOT is used as an adjuvant in the management of various diseases. A large number of studies have been published to confirm its efficacy. Although HBOT has been clinically applied to the treatment of many diseases, the effectiveness of these treatments remains controversial. Exploring and evaluating HBOT will contribute to the future development of research in this field. Through a quantitative analysis of the literature, this paper explores the citation relevance and collaboration map and their impact on research outcomes. This study used bibliometric and cartographic techniques with VOSviewer to identify the most influential countries and scholars using this treatment, based on syndrome differentiation. It also provides continuous quality evaluation and lean management of the medical expenses associated with HBOT.
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Affiliation(s)
- Nan-Chieh Huang
- Department of Information Engineering, I-Shou University, Kaohsiung City 84001, Taiwan;
- Division of Family Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City 813204, Taiwan
| | - Yu-Lung Wu
- Department of Information Management, I-Shou University, Kaohsiung City 84001, Taiwan;
| | - Ren-Fang Chao
- Department of Leisure Management, I-Shou University, Kaohsiung City 84001, Taiwan
- Correspondence:
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Au SCL. Identifying the correct diagnosis on multimodal imaging for retinal vascular diseases. QJM 2022; 116:319-320. [PMID: 35639712 DOI: 10.1093/qjmed/hcac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sunny Chi Lik Au
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong
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