Metelitsina T I, Grunwald J E, DuPont J C, Ying G-S
Department of Opthalmology, Scheie Eye Institute, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Br J Ophthalmol. 2006 Mar;90(3):342-6. doi: 10.1136/bjo.2005.082974.
To investigate the effect of systemic hypertension (SH) on the foveolar choroidal circulation in patients with age related macular degeneration (AMD).
This study included 163 study eyes with early AMD characteristics of 124 AMD patients. Study eyes had visual acuity of 20/40 or better, drusen > or =63 microm, and/or RPE hypertrophy. 56 of the AMD patients had a history of SH and 47 of these patients were receiving antihypertensive medications. Laser Doppler flowmetry (Oculix) was used to assess relative choroidal blood velocity (ChBVel), volume (ChBVol), and flow (ChBFlow) in the centre of the fovea of the study eyes. Differences in the mean haemodynamic parameters between groups of eyes were assessed using analysis of variance (ANOVA) and a test of linear trend, with adjustment for the correlation between eyes of the same patient.
AMD patients with SH showed decreased ChBFlow in comparison with those without SH (ANOVA, p = 0.02). This association was maintained after adjustments for multiple factors (p = 0.04).
AMD patients with SH have lower ChBFlow than those without SH. This decrease in choroidal blood circulation may help explain the mechanism by which systemic hypertension may contribute to the progression of AMD and the development of choroidal neovascularisation.
研究系统性高血压（SH）对年龄相关性黄斑变性（AMD）患者黄斑中心凹脉络膜循环的影响。
本研究纳入了124例AMD患者的163只具有早期AMD特征的研究眼。研究眼的视力为20/40或更好，玻璃膜疣≥63微米，和/或视网膜色素上皮（RPE）肥厚。56例AMD患者有SH病史，其中47例患者正在接受抗高血压药物治疗。使用激光多普勒血流仪（Oculix）评估研究眼黄斑中心凹处的相对脉络膜血流速度（ChBVel）、容积（ChBVol）和流量（ChBFlow）。采用方差分析（ANOVA）和线性趋势检验评估各组眼之间平均血流动力学参数的差异，并对同一患者双眼之间的相关性进行校正。
与无SH的AMD患者相比，有SH的AMD患者ChBFlow降低（ANOVA，p = 0.02）。在对多个因素进行校正后，这种关联仍然存在（p = 0.04）。
有SH的AMD患者的ChBFlow低于无SH的患者。脉络膜血液循环的这种降低可能有助于解释系统性高血压可能导致AMD进展和脉络膜新生血管形成的机制。
