Aoki N
Jpn Circ J. 1975 Mar;39(3):271-82. doi: 10.1253/jcj.39.271.
The interrelationship of the funduscopic, physical and laboratory findings, the additional information of each funduscopic finding when physical and laboratory findings were considered simultaneously, and the relative importance of each retinal finding in the funduscopic pictures were investigated by a series of multivariate analysis for 68 cerebral hemorrhage, 47 cerebral thrombosis and 230 controls in two rural towns, Akabane and Asahi, in Japan and the results were as follows: 1. For the occurrence of cerebral hemorrhage, narrowing of arteriole and irregular constriction were especially important indicators, and retinal bleeding and lateral displacement were also valuable but less than narrowing and irregular constriction. On the other hand, for the occurrence of cerebral thrombosis, arteriolar reflex was considered as the most valuable indicator, and irregular constriction, lateral displacement and white plaque were also important but less than arteriolar reflex. 2. Narrowing of arteriole was most highly related with irregular constriction while the correlation between retinal bleeding and white plaque, and also the correlation between arteriolar reflex, vertical and lateral displacement and tapering were significant. 3. A significiant correlation among physical and laboratory findings was found only between systolic and diastolic blood pressure as far as analysed. Funduscopic findings by Scheie's hypertensive and Keith-Wagener's classifications were highly correlated with systolic and diastolic blood pressure. 4. Narrowing and irregular constriction were significantly correlated with systolic and diastolic blood pressure, and the relation between retinal bleeding and glycosuria was significant. 5. An analysis of the additional information of each funduscopic finding, when evaluated with the physical and laboratory findings simultaneously, revealed that irregular constriction, lateral displacement and narrowing gave prominent additional information for the occurrence of cerebral hemorrhage, while arteriolar reflex, lateral and vertical displacement and white plaque gave valuable information for the occurrence of cerebral thrombosis. 6. It is noteworthy from these multivariate analyses that narrowing and irregular constriction may arise from a similar pathophysiological mechanism which brings out vasoconstriction and the resultant organic changes due to hypertension. It is also noticed that arteriolar reflex and A/V crossing phenomenon may come from the different pathophysiological mechanism related to arteriosclerosis. It was stressed that detailed analyses of observer variability and evolution of funduscopic findings would be necessary.
通过对日本赤羽和旭两个乡村城镇的68例脑出血、47例脑血栓形成患者及230例对照者进行一系列多变量分析，研究了眼底镜检查、体格检查和实验室检查结果之间的相互关系，同时考虑体格检查和实验室检查结果时每项眼底镜检查结果的附加信息，以及眼底镜图像中每项视网膜检查结果的相对重要性，结果如下：1. 对于脑出血的发生，小动脉狭窄和不规则收缩是特别重要的指标，视网膜出血和侧移位也有价值，但不如狭窄和不规则收缩。另一方面，对于脑血栓形成的发生，小动脉反射被认为是最有价值的指标，不规则收缩、侧移位和白色斑块也很重要，但不如小动脉反射。2. 小动脉狭窄与不规则收缩的相关性最高，而视网膜出血与白色斑块之间的相关性，以及小动脉反射、垂直和侧移位与变细之间的相关性也很显著。3. 就分析而言，仅在收缩压和舒张压之间发现了体格检查和实验室检查结果之间的显著相关性。Scheie高血压分类和Keith-Wagener分类的眼底镜检查结果与收缩压和舒张压高度相关。4. 狭窄和不规则收缩与收缩压和舒张压显著相关，视网膜出血与糖尿之间的关系显著。5. 当同时用体格检查和实验室检查结果进行评估时，对每项眼底镜检查结果的附加信息进行分析发现，不规则收缩、侧移位和狭窄为脑出血的发生提供了突出的附加信息，而小动脉反射、侧和垂直移位以及白色斑块为脑血栓形成的发生提供了有价值的信息。6. 从这些多变量分析中值得注意的是，狭窄和不规则收缩可能源于类似的病理生理机制，该机制导致血管收缩以及由于高血压引起的继发器质性改变。还注意到小动脉反射和动静脉交叉现象可能源于与动脉硬化相关的不同病理生理机制。强调有必要对观察者变异性和眼底镜检查结果的演变进行详细分析。
