Wong Tien Yin, McIntosh Rachel
Centre for Eye Research Australia, University of Melbourne.
Ophthalmic Physiol Opt. 2005 May;25(3):195-204. doi: 10.1111/j.1475-1313.2005.00288.x.
Retinal microvascular signs, such as generalized retinal arteriolar narrowing, focal arteriolar narrowing, arteriovenous nicking and retinal haemorrhages, microaneurysms and cotton wool spots, are common fundus findings in the general population, even in individuals without hypertension or diabetes. Recent population-based studies have provided new insights into the systemic associations and clinical significance of these retinal signs. Studies show that these retinal microvascular signs are strongly associated with elevated blood pressure (BP). Generalized retinal arteriolar narrowing may be associated with markers of inflammation and risk of diabetes and hypertension. Retinal haemorrhages, microaneurysms and cotton wool spots are associated with risk of subclinical and clinical stroke, cognitive impairment, renal dysfunction and cardiovascular mortality, independent of BP and cardiovascular risk factors. A consistent pattern of association between retinal microvascular signs and ischaemic heart disease has not been demonstrated. This suggests that patients with some retinopathy signs (retinal haemorrhages, microaneurysms and cotton wool spots) may benefit from a careful systemic evaluation and, if supported by further research, appropriate risk reduction therapy.
视网膜微血管体征，如广泛性视网膜小动脉狭窄、局灶性小动脉狭窄、动静脉交叉压迫以及视网膜出血、微动脉瘤和棉絮斑，在普通人群中是常见的眼底表现，即使在没有高血压或糖尿病的个体中也是如此。最近基于人群的研究为这些视网膜体征的全身关联和临床意义提供了新的见解。研究表明，这些视网膜微血管体征与血压升高密切相关。广泛性视网膜小动脉狭窄可能与炎症标志物以及糖尿病和高血压风险有关。视网膜出血、微动脉瘤和棉絮斑与亚临床和临床中风、认知障碍、肾功能不全及心血管死亡率风险相关，独立于血压和心血管危险因素。视网膜微血管体征与缺血性心脏病之间尚未证实存在一致的关联模式。这表明，有某些视网膜病变体征（视网膜出血、微动脉瘤和棉絮斑）的患者可能受益于仔细的全身评估，如果有进一步研究支持，还可能受益于适当的风险降低治疗。
