一例颈内动脉未闭塞但眼动脉血流逆转的病例
[A case of reversed ophthalmic artery flow without occlusion of the internal carotid artery].
作者信息
Souma N, Tasaka Y, Nakauchi K, Kubota Y, Amano Y, Sogabe T
机构信息
Department of Ophthalmology, Matsuyama Red Cross Hospital, Japan.
出版信息
Nippon Ganka Gakkai Zasshi. 2000 Apr;104(4):255-9.
BACKGROUND
We report a case of reversed ophthalmic artery (OA) flow showing neither occlusion of the internal carotid artery (ICA) nor ophthalmic symptoms.
CASE
An 82-year-old man had transient blindness in both eyes. After left carotid endarterectomy, ophthalmic symptoms improved in the right and left eyes. Afterwards, he had a relapse in the left eye.
RESULTS
There was no unusual impression in the ophthalmic examinations, but color Doppler imaging showed reduced flow in the left OA, reversal of flow direction in the right OA. The central retinal artery (CRA) and short posterior ciliary arteries (SPCA) were not detected in the left eye but were detected in the right eye. Digital subtraction angiography demonstrated that the right OA was not contrasted with the right ICA, despite there being no stenosis or occlusion of the right ICA.
CONCLUSIONS
We suggest that carotid surgery may affect the ocular circulation of the opposite side, and reversed OA flow as a collateral pathway from the external carotid artery may occur in the absence of carotid artery stenosis. Good circulation of the CRA and SPCA may preclude manifestation of ophthalmic symptoms even if the OA flow is reversed.
背景
我们报告一例眼动脉（OA）血流逆转的病例，该病例既无颈内动脉（ICA）闭塞，也无眼部症状。
病例
一名82岁男性双眼出现短暂失明。左颈动脉内膜切除术后，双眼的眼部症状均有改善。之后，他左眼复发。
结果
眼科检查未发现异常，但彩色多普勒成像显示左OA血流减少，右OA血流方向逆转。左眼未检测到视网膜中央动脉（CRA）和睫状后短动脉（SPCA），但右眼检测到。数字减影血管造影显示，尽管右侧ICA无狭窄或闭塞，但右侧OA未与右侧ICA显影。
结论
我们认为颈动脉手术可能影响对侧眼循环，在无颈动脉狭窄的情况下，可能会出现作为来自颈外动脉的侧支途径的OA血流逆转。即使OA血流逆转，CRA和SPCA的良好循环可能也会阻止眼部症状的表现。
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