Hansen Grith Lssrkholm, Kofoed Peter Kristian, Munch Inger Christine, Sillesen Henrik, Jensen Leif Panduro, Iversen Helle K, Larsen Michael
Øjenafdelingen, Glostrup Hospital, Ndr. Ringvej 57, 2600 Glostrup, Denmark.
Dan Med J. 2013 Oct;60(10):A4716.
The aim of this study was to examine the use of quantitative fluorescein angiographic analysis as a means of estimating rates of perfusion of the retina in eyes with a circulatory deficit secondary to carotid artery stenosis.
The study included 21 eyes with ocular ischaemic syndrome (OIS) and 20 control eyes from subjects with carotid artery stenosis but without signs of ocular ischaemia. Analyses of video fluorescein angiograms extracting time intervals for the time delay between specific phases of the angiogram were performed. Time delay was compared between groups and in relation to degree of carotid artery stenosis and ocular systolic blood pressure.
Among the three flow indices of retinal perfusion (arteriovenous passage time 1 (AVP1), arteriovenous passage time 2 (AVP2) and venous filling time (VP)), those including the venous filling phase were significantly prolonged in the OIS group. Furthermore, AVP2 was delayed by 3 sec. in OIS eyes (16.6 sec. versus 13.6 sec. in controls). VP was 2.4 sec. longer in OIS eyes (11.5 sec. versus 9.1 sec.). We found a significant correlation between AVP2 and ocular perfusion pressure, but no correlation between the degree of carotid artery stenosis and any of the flow indices.
In a patient population spanning a wide ocular systolic blood pressure range, angiography-based quantitative flowmetry demonstrated a difference between carotid artery stenosis patients with and without OIS and a correlation between flow and ocular perfusion pressure. While angiographic flowmetry proved effective in discriminating between groups of individuals, it can only be used to support the diagnosis of the ocular ischaemic syndrome in patients with extreme flow reduction.
本研究的目的是探讨定量荧光素血管造影分析作为评估因颈动脉狭窄继发循环障碍的眼睛视网膜灌注率的一种方法。
该研究纳入了21只患有眼部缺血综合征（OIS）的眼睛以及20只来自患有颈动脉狭窄但无眼部缺血体征受试者的对照眼睛。对视频荧光素血管造影进行分析，提取血管造影特定阶段之间的时间延迟的时间间隔。比较了两组之间以及与颈动脉狭窄程度和眼收缩压相关的时间延迟。
在视网膜灌注的三个血流指数（动静脉通过时间1（AVP1）、动静脉通过时间2（AVP2）和静脉充盈时间（VP））中，包括静脉充盈期的那些指数在OIS组中显著延长。此外，OIS组眼睛的AVP2延迟了3秒（分别为16.6秒和对照组的13.6秒）。OIS组眼睛的VP长2.4秒（分别为11.5秒和9.1秒）。我们发现AVP2与眼灌注压之间存在显著相关性，但颈动脉狭窄程度与任何血流指数之间均无相关性。
在一个眼收缩压范围广泛的患者群体中，基于血管造影的定量血流测量显示有眼部缺血综合征和无眼部缺血综合征的颈动脉狭窄患者之间存在差异，并且血流与眼灌注压之间存在相关性。虽然血管造影血流测量被证明在区分个体组方面有效，但它只能用于支持血流极度降低患者的眼部缺血综合征的诊断。
