網膜中心動脈閉塞症に対する星状神経節ブロック高圧酸素療法の治療成績

Central retinal artery obstruction and visual prognosis

　網膜中心動脈閉塞症23例23眼に，星状神経節ブロックと，高圧酸素療法または高濃度酸素吸入療法を施行し視力予後を，retrospectiveに検討した．治療後，視力が改善した例は16例70％で，0.1以上に回復した例は10例43％であった．その視力予後は，治療前の視力が指数弁以上の8例では，発症から治療開始までの期間に関係なく，すべて0.1以上と良好であった．これに対し，手動弁以下の15例では，2例を除いて全例が0.05以下であった．またこの症例群で，治療開始までの期間が短い程，視力予後が良い傾向があった．

We evaluated the visual prognosis of a consecu-tive series of 23 cases with central retinal artery occlusion treated by stellate ganglion block andhyperbaric oxygen or inhalation therapy by 95% oxygen mixed with 5% carbon dioxide.

Visual acuity improved in 16 cases (70%) follow-ing the treatment. Final visual acuity was 0.1 or better in 10 cases (43%). Regardless of the interval between the onset of disease and start of treatment, the prognosis was generally favorable when the initial visual acuity was better than counting fin-gers. The present series included 8 eyes with an initial visual cuity of counting fingers or better. All the cases attained visual acuity of 0.1 or more. Conversely, a poor prognosis was the rule if the initial visual acuity was hand movement or less. The present series included 15 such cases. The visual outcome was 0.05 or less in all the cases except 2. In the latter group, the interval between the onset of symptom and start of treatments was crucial. Early treatment is recommended for centralretinal artery occlusion, particularly for those with poor visual acuity.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(6) : 611-614, 1987