Department of Ophthalmology, Carl Gustav Carus University Hospital, Fetscherstr. 74, 01307 Dresden, Germany.
Br J Ophthalmol. 2011 Mar;95(3):401-4. doi: 10.1136/bjo.2010.180901. Epub 2010 Jun 8.
To investigate the effect of low-density lipoprotein (LDL) apheresis on ocular microcirculation in patients with hypercholesterolaemia.
Six patients with hypercholesterolaemia were included in this study. The diameter of retinal vessels was measured continuously with the retinal vessel analyser before and after LDL apheresis. After baseline assessment a monochromatic luminance flicker was applied to evoke retinal vasodilation. Flicker response was then analysed 50, 70 and 120 s after baseline measurement. In addition, cholesterol, high-density lipoprotein, LDL and triglyceride levels were obtained to find a possible correlation between changes in retinal vessel diameter and lipid metabolism before and after apheresis.
The mean diameter of the arterioles at baseline was 107.6±2.1 μm and the mean diameter of the venules at baseline was 132.8±3.2 μm. The diameter of the arterioles after apheresis increased to 111.2±2.3 μm after 50 s, 113.2±2.6 μm after 70 s and 113.7±2.6 μm after 120 s, showing a trend to statistical significance at all time points (p=0.046, p=0.028 and p=0.028, respectively). The mean diameter of the venules after apheresis increased to 138.8±5.9 μm after 50 s, 139.8±6.3 μm after 70 s and 141.2±6.0 μm after 120 s, showing a trend to statistical significance at all time points (all p=0.028).
Changes in retinal vascular diameter seem to be associated with the systemic effect of a single LDL apheresis. Vasodilatation of the arterioles and the venules improved after LDL apheresis, indicating an improvement of ocular perfusion in patients with hypercholesterolaemia.
探讨 LDL 吸附治疗对高胆固醇血症患者眼微循环的影响。
本研究纳入了 6 例高胆固醇血症患者。在 LDL 吸附治疗前后，使用视网膜血管分析仪连续测量视网膜血管直径。在基线评估后，应用单色亮度闪烁刺激诱发视网膜血管扩张。在基线测量后 50、70 和 120 秒分析闪烁反应。此外，还检测了胆固醇、高密度脂蛋白、LDL 和甘油三酯水平，以寻找治疗前后视网膜血管直径变化与脂代谢之间的可能相关性。
基线时，动脉的平均直径为 107.6±2.1μm，静脉的平均直径为 132.8±3.2μm。治疗后 50 秒时，动脉直径增加至 111.2±2.3μm，70 秒时增加至 113.2±2.6μm，120 秒时增加至 113.7±2.6μm，所有时间点均呈统计学意义（p=0.046、p=0.028 和 p=0.028）。治疗后 50 秒时，静脉的平均直径增加至 138.8±5.9μm，70 秒时增加至 139.8±6.3μm，120 秒时增加至 141.2±6.0μm，所有时间点均呈统计学意义（均 p=0.028）。
视网膜血管直径的变化似乎与单次 LDL 吸附的全身作用有关。LDL 吸附治疗后，动脉和静脉均出现扩张，表明高胆固醇血症患者的眼灌注得到改善。
