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已发表论文
视网膜中央动脉阻塞患者眼底改变与视力预后的关联
Authors Wang H , Wei H, Dong J, Fang R, Jiang M, Chang Y, Yang R, Zhang F, Yan S, Gao Z, Zhu L, Sun H, Jin L, Li X, Zhang M
Received 21 September 2025
Accepted for publication 16 December 2025
Published 26 December 2025 Volume 2025:19 Pages 4913—4924
DOI https://doi.org/10.2147/OPTH.S568753
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Yousef Fouad
Hao Wang,1– 3 Hongyu Wei,4 Jieying Dong,5 Ruizhen Fang,3 Mei Jiang,6 Yongye Chang,2 Rong Yang,2 Fen Zhang,7 Suxia Yan,2 Zhimin Gao,2 Liping Zhu,2 Huijing Sun,2 Lihui Jin,2 Xiaorong Li,1 Minglian Zhang2
1Tianjin Medical University Eye Hospital/Eye Institute, Tianjin Medical University, Tianjin, People’s Republic of China; 2Department of TCM Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China; 3North China University of Science and Technology, Tangshan, Hebei, People’s Republic of China; 4Hebei Provincial Hospital of Traditional Chinese Medicine Affiliated to Hebei University of Chinese Medicine, Shijiazhuan, Hebei, People’s Republic of China; 5Department of Pharmacy, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China; 6Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK; 7Department of Ophthalmology, Xiangya Changde Hospital, Changde, Hunan, People’s Republic of China
Correspondence: Minglian Zhang, Department of TCM Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China, Email zhmlyk@sohu.com Xiaorong Li, Tianjin Medical University Eye Hospital/Eye Institute, Tianjin Medical University, Tianjin, People’s Republic of China, Email xiaorli@163.com
Purpose: To study the association between fundus changes and visual prognosis in central retinal artery occlusion (CRAO).
Methods: A total of 222 CRAO cases hospitalized at Hebei Eye Hospital between January 2013 and December 2016 were included in this study. Fundus photographs on admission were evaluated via dual independent image review. Retinal ischemic edema and cilioretinal arteries were graded. Logistic regression analysis was performed to explore the association between fundus findings and visual prognosis in CRAO.
Results: The main fundus changes in CRAO patients on admission included retinal ischemic edema (95.0%), cherry-red spot (89.6%), retinal arterial narrowing (65.3%) and venous narrowing (53.6%), cotton-wool spots (53.6%), optic disc margin blurring (36.0%) and pallor (35.1%), retinal venous dilation (21.2%), and retinal hemorrhages (12.6%). Upon admission, retinal edema grades were grade 0 in 11 eyes (5.0%), grade 1 in 23 (10.4%), grade 2 in 80 (36.0%); and grade 3 in 108 (48.6%). Forty-seven eyes (21.1%) showed fissure-like edema, while 164 eyes (73.9%) exhibited a diffuse pattern. Chi square test showed the grade and pattern of retinal ischemic edema, the border and size of the cherry-red spot, the presence of retinal hemorrhage and cotton wool spots, macular folds and retinal arterial narrowing were all significantly associated with the time from symptom onset to presentation. Multivariate logistic regression analysis identified visual acuity at presentation, retinal ischemic grade, optic disc margin clarity, cherry-red spot size, and the presence of a cilioretinal artery supplying the macula as predictive factors for visual prognosis in CRAO.
Conclusion: The fundus changes in acute CRAO were correlated with the visual prognosis. Visual acuity at presentation, grade of retinal ischemic edema, clarity of the optic disc margin, size of the cherry-red spot, and the presence of a cilioretinal artery supplying the macula could be predictive factors for visual prognosis in CRAO.
Keywords: central retinal artery occlusion, visual prognosis, retinal ischemic edema, cherry red spot, vascular change, predictive factor
1Tianjin Medical University Eye Hospital/Eye Institute, Tianjin Medical University, Tianjin, People’s Republic of China; 2Department of TCM Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China; 3North China University of Science and Technology, Tangshan, Hebei, People’s Republic of China; 4Hebei Provincial Hospital of Traditional Chinese Medicine Affiliated to Hebei University of Chinese Medicine, Shijiazhuan, Hebei, People’s Republic of China; 5Department of Pharmacy, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China; 6Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK; 7Department of Ophthalmology, Xiangya Changde Hospital, Changde, Hunan, People’s Republic of China
Correspondence: Minglian Zhang, Department of TCM Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei, People’s Republic of China, Email zhmlyk@sohu.com Xiaorong Li, Tianjin Medical University Eye Hospital/Eye Institute, Tianjin Medical University, Tianjin, People’s Republic of China, Email xiaorli@163.com
Purpose: To study the association between fundus changes and visual prognosis in central retinal artery occlusion (CRAO).
Methods: A total of 222 CRAO cases hospitalized at Hebei Eye Hospital between January 2013 and December 2016 were included in this study. Fundus photographs on admission were evaluated via dual independent image review. Retinal ischemic edema and cilioretinal arteries were graded. Logistic regression analysis was performed to explore the association between fundus findings and visual prognosis in CRAO.
Results: The main fundus changes in CRAO patients on admission included retinal ischemic edema (95.0%), cherry-red spot (89.6%), retinal arterial narrowing (65.3%) and venous narrowing (53.6%), cotton-wool spots (53.6%), optic disc margin blurring (36.0%) and pallor (35.1%), retinal venous dilation (21.2%), and retinal hemorrhages (12.6%). Upon admission, retinal edema grades were grade 0 in 11 eyes (5.0%), grade 1 in 23 (10.4%), grade 2 in 80 (36.0%); and grade 3 in 108 (48.6%). Forty-seven eyes (21.1%) showed fissure-like edema, while 164 eyes (73.9%) exhibited a diffuse pattern. Chi square test showed the grade and pattern of retinal ischemic edema, the border and size of the cherry-red spot, the presence of retinal hemorrhage and cotton wool spots, macular folds and retinal arterial narrowing were all significantly associated with the time from symptom onset to presentation. Multivariate logistic regression analysis identified visual acuity at presentation, retinal ischemic grade, optic disc margin clarity, cherry-red spot size, and the presence of a cilioretinal artery supplying the macula as predictive factors for visual prognosis in CRAO.
Conclusion: The fundus changes in acute CRAO were correlated with the visual prognosis. Visual acuity at presentation, grade of retinal ischemic edema, clarity of the optic disc margin, size of the cherry-red spot, and the presence of a cilioretinal artery supplying the macula could be predictive factors for visual prognosis in CRAO.
Keywords: central retinal artery occlusion, visual prognosis, retinal ischemic edema, cherry red spot, vascular change, predictive factor