Ma Feiyan, Su Jing, Shang Qingli, Ma Jingxue, Zhang Tongdi, Wang Xin, Ma Honglei, Yu Jianghua
a Department of Ophthalmology , The Second Hospital of Hebei Medical University , Shijiazhuang China.
b B-mode Ultrasonography , The Second Hospital of Hebei Medical University , Shijiazhuang China.
Curr Eye Res. 2018 Feb;43(2):266-272. doi: 10.1080/02713683.2017.1390771. Epub 2017 Nov 14.
To evaluate the effects of carotid artery angioplasty and stenting (CAAS) on patients who were diagnosed with ocular ischemic syndrome (OIS).
Sixty-four eyes of 64 OIS patients with ipsilateral internal carotid artery stenosis ≥70% were included in the study. The study eyes were divided into two groups according to the presence of iris neovascularization: NVI-absent group and NVI-present group, with 32 eyes, respectively. All patients received ocular treatment modality according to the presence of non-perfusion area (pan-retinal photocoagulation) and intraocular pressure (medical treatment included timolol maleate eye drops combined with brinzolamide eye drop; trabeculectomy and cyclophotocoagulation). All patients went through CAAS surgery for treatment of internal carotid artery stenosis. Best-corrected visual acuity (BCVA); intraocular pressure (IOP), slit lamp examination, iris fluorescence angiography, fundus fluorescein angiography and color Doppler ultrasound of the internal carotid artery (ICA), ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (PCA) were performed pre-operatively and 1 month, 3 months, 6 months, and 12 months post-operatively.
There was no significant BCVA change postoperatively in the NVI-absent group, while postoperative BCVA in the INV-present group decreased significantly. There was no significant BCVA difference at pre-operative and 1month post-operative follow-up between the two groups. However, post-operative BCVA of NVI-present group starting from 3-months follow-up was significantly worse than NVI-absent group. Arm-retinal artery circulation time and arteriovenous circulation time decreased significantly in NVI-absent group, while showed no statistical difference in NVI-present group during the 12-months follow-up. Postoperative peak systolic velocity (PSV) of the ophthalmic artery, the central retinal artery, and short posterior ciliary artery showed significant increases at 1 month, 3 months, 6 months and 12 months follow-up in both groups.
CAAS can greatly improve ocular blood in OIS patients with and without iris neovascularization. However, CAAS improved BCVA only in patients without iris neovascularization.
评估颈动脉血管成形术和支架置入术（CAAS）对诊断为眼部缺血综合征（OIS）患者的影响。
本研究纳入64例同侧颈内动脉狭窄≥70%的OIS患者的64只眼。研究眼根据虹膜新生血管的有无分为两组：无虹膜新生血管组和有虹膜新生血管组，每组各32只眼。所有患者根据有无无灌注区（全视网膜光凝）和眼压情况接受眼部治疗方式（眼压治疗包括马来酸噻吗洛尔滴眼液联合布林佐胺滴眼液；小梁切除术和睫状体光凝术）。所有患者均接受CAAS手术治疗颈内动脉狭窄。术前及术后1个月、3个月、6个月和12个月进行最佳矫正视力（BCVA）、眼压（IOP）、裂隙灯检查、虹膜荧光血管造影、眼底荧光血管造影以及颈内动脉（ICA）、眼动脉（OA）、视网膜中央动脉（CRA）和睫状后短动脉（PCA）的彩色多普勒超声检查。
无虹膜新生血管组术后BCVA无显著变化，而有虹膜新生血管组术后BCVA显著下降。两组术前和术后1个月随访时BCVA无显著差异。然而，有虹膜新生血管组术后从3个月随访开始的BCVA明显差于无虹膜新生血管组。无虹膜新生血管组臂视网膜动脉循环时间和动静脉循环时间显著缩短，而有虹膜新生血管组在12个月随访期间无统计学差异。两组术后1个月、3个月、6个月和12个月随访时眼动脉、视网膜中央动脉和睫状后短动脉的术后收缩期峰值速度（PSV）均显著增加。
CAAS可显著改善有或无虹膜新生血管的OIS患者的眼部血液供应。然而，CAAS仅能改善无虹膜新生血管患者的BCVA。
