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基于光学相干断层扫描的视网膜血管分析用于评估高血压性血管病变。

Optical coherence tomography-based retinal vessel analysis for the evaluation of hypertensive vasculopathy.

作者信息

Schuster Alexander Karl-Georg, Fischer Joachim Ernst, Vossmerbaeumer Christine, Vossmerbaeumer Urs

机构信息

Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany.

出版信息

Acta Ophthalmol. 2015 Mar;93(2):e148-53. doi: 10.1111/aos.12509. Epub 2014 Aug 11.

Abstract

PURPOSE

Evaluation of retinal vessels in cardiovascular disease traditionally relies upon funduscopy, but more recently digital photo analysis has expanded the spectrum. As spectral domain optical coherence tomography (OCT) allows an in-vivo assessment of retinal tissue and its vessels on a histological scale, our study aimed at using this tool for the analysis of the retinal vasculature.

METHODS

Circumferential peripapillary OCT scans (3DOCT-2000; Topcon Inc., Tokyo, Japan), with centration on the optic nerve head, were taken from 20 eyes (20 participants) with normal blood pressure and 20 eyes (20 participants) with arterial hypertension above 120 mmHg (mean blood pressure). The diameter of all vessels intersecting the scan line was measured in the OCT and used to calculate central vessel equivalents, and the A/V ratios were calculated. Bland-Altman analysis was performed to evaluate reliability. Correlation coefficients were determined for reliability of the method as well as with the individual mean arterial blood pressures.

RESULTS

Forty eyes (40 participants) were included in the study. Mean arterial blood pressure was 96±4 mmHg in the control group and 132±7 mmHg in the hypertonic group. Mean A/V ratio as determined from OCT scans was 0.82±0.13 (normotonic) versus 0.62±0.11 (hypertonic). A Pearson's correlation coefficient of 0.67 (p<0.001) was determined between A/V ratio and blood pressure.

CONCLUSIONS

Our results highlight the feasibility of retinal vessel measurements in spectral domain OCT. A relation between mean arterial blood pressure and OCT-based A/V ratio was established. Further research will elucidate influencing factors and provide a broader basis for therapeutic approaches.

摘要

目的

传统上,心血管疾病中视网膜血管的评估依赖于眼底镜检查,但最近数字照片分析扩展了评估范围。由于光谱域光学相干断层扫描(OCT)能够在组织学层面上对视网膜组织及其血管进行活体评估,我们的研究旨在使用该工具分析视网膜血管系统。

方法

对20只血压正常的眼睛(20名参与者)和20只平均血压高于120 mmHg的动脉高血压患者的眼睛(20名参与者)进行环绕视乳头周围的OCT扫描(3DOCT - 2000;日本东京拓普康公司),扫描中心对准视神经乳头。在OCT中测量与扫描线相交的所有血管的直径,用于计算中央血管等效值,并计算动静脉比值。采用Bland - Altman分析评估可靠性。确定该方法的可靠性以及与个体平均动脉血压的相关系数。

结果

40只眼睛(40名参与者)纳入研究。对照组平均动脉血压为96±4 mmHg,高血压组为132±7 mmHg。通过OCT扫描确定的平均动静脉比值,血压正常组为0.82±0.13,高血压组为0.62±0.11。动静脉比值与血压之间的Pearson相关系数为0.67(p<0.001)。

结论

我们的结果突出了光谱域OCT测量视网膜血管的可行性。建立了平均动脉血压与基于OCT的动静脉比值之间的关系。进一步的研究将阐明影响因素,并为治疗方法提供更广泛的基础。

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