Samardzic Kristian, Samardzic Pejo, Vujeva Bozo, Prvulovic Djeiti, Latic-Hodzic Leila
General hospital Dr. Josip Bencevic, Slavonski Brod, Croatia.
Med Arh. 2012;66(1):66-7.
To determine the occurence of embolism in retinal circulation after invasive cardiovascular procedures and the risk of central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO).
During a 3 month period 153 patients (303 eyes)--101 male/52 female--who had undergone coronarography or stent implantation were examined before and 24 hours after the procedure. Best corrected visual acuity (BCVA) was taken, visual field examination was done and fundoscopy was performed. Eyes with the opacities in the anterior segment (corneal leucoma, dense cataracts) were excluded from the study. Prior to invasive procedure none of the patients had embolism in the retinal circulation.
Embolism was found in 3 patients (male) who all had hyperlipidemia with normal blood pressure. Two of them had coronarography and one patient had stent implantation. One of the patients had a previous branch retinal vein occlusion (BRVO) that was treated with photocoagulation. They did not report any symptoms. BCVA was the same before and after the procedure. Two of the emboli were located in the first branch of the central retinal artery and one was located in the branch of cillioretinal artery. All of the emboli were transient after 48 hours.
The study showed that invasive cardiovascular procedures do have the risk of developing transient embolism in retinal circulation. However, there have been reports of CRAO and BRAO after diagnostic cardiac procedures, therefore clinicians should be aware of this potential complication.
确定侵入性心血管手术后视网膜循环中栓塞的发生率以及视网膜中央动脉阻塞（CRAO）和视网膜分支动脉阻塞（BRAO）的风险。
在3个月期间，对153例患者（303只眼）——101例男性/52例女性——进行了冠状动脉造影或支架植入术，在手术前和术后24小时进行检查。测量最佳矫正视力（BCVA），进行视野检查并实施眼底镜检查。前段有混浊（角膜白斑、致密白内障）的眼睛被排除在研究之外。在侵入性手术前，所有患者视网膜循环中均无栓塞。
在3例患者（男性）中发现栓塞，他们均患有高脂血症且血压正常。其中2例进行了冠状动脉造影，1例进行了支架植入。其中1例患者既往有视网膜分支静脉阻塞（BRVO），已接受光凝治疗。他们均未报告任何症状。手术前后BCVA相同。2个栓子位于视网膜中央动脉的第一分支，1个位于睫状视网膜动脉分支。所有栓子在48小时后均为短暂性。
该研究表明，侵入性心血管手术确实有在视网膜循环中发生短暂性栓塞的风险。然而，有诊断性心脏手术后发生CRAO和BRAO的报道，因此临床医生应意识到这种潜在并发症。
