通过测量眼脉搏振幅诊断海绵窦动静脉瘘
Diagnosis of cavernous sinus arteriovenous fistula by measurement of ocular pulse amplitude.
作者信息
Golnik K C, Miller N R
机构信息
Wilmer Institute, Johns Hopkins Hospital, Baltimore.
出版信息
Ophthalmology. 1992 Jul;99(7):1146-52. doi: 10.1016/s0161-6420(92)31838-x.
BACKGROUND
The ocular pulse amplitude (OPA), the difference between the maximum and minimum intraocular pressure (IOP) during the cardiac cycle, has been reported to be elevated in the eye ipsilateral to a cavernous sinus arteriovenous fistula.
METHODS
The OPA was measured with a pneumotonometer in three groups of patients. Patients in group 1 had no orbital disease (n = 50), patients in group 2 had either unilateral or asymmetric orbital disease (n = 30), and patients in group 3 had angiographically proven cavernous sinus arteriovenous fistulas (n = 15).
RESULTS
Patients in group 3 had a higher OPA than patients in either group 1 (P less than 0.001) or group 2 (P less than 0.001). The difference in OPA between an individual's eyes (delta OPA) also was higher in patients with cavernous sinus arteriovenous fistulas than in patients without fistulas (P less than 0.0001).
CONCLUSION
A delta OPA of more than 1.6 mmHg was 100% sensitive and 93% specific in identifying patients with cavernous sinus arteriovenous fistulas. There was no difference in delta OPA between direct and dural cavernous sinus arteriovenous fistulas. Successful transvascular embolization of the cavernous sinus arteriovenous fistula normalized the delta OPA by reducing the OPA on the affected side.
背景
眼动脉搏动幅度（OPA）是心动周期中眼内压（IOP）最大值与最小值之差，据报道，海绵窦动静脉瘘同侧眼的OPA会升高。
方法
用空气眼压计测量三组患者的OPA。第1组患者无眼眶疾病（n = 50），第2组患者有单侧或不对称眼眶疾病（n = 30），第3组患者经血管造影证实患有海绵窦动静脉瘘（n = 15）。
结果
第3组患者的OPA高于第1组（P < 0.001）或第2组患者（P < 0.001）。海绵窦动静脉瘘患者双眼间的OPA差值（ΔOPA）也高于无瘘患者（P < 0.0001）。
结论
ΔOPA大于1.6 mmHg在识别海绵窦动静脉瘘患者时敏感性为100%，特异性为93%。直接型和硬脑膜型海绵窦动静脉瘘之间的ΔOPA没有差异。成功的海绵窦动静脉瘘经血管栓塞术通过降低患侧的OPA使ΔOPA恢复正常。
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