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眼部缺血综合征的多模态成像评估

Multimodality Imaging Assessment of Ocular Ischemic Syndrome.

作者信息

Wang Hui, Wang Yanling, Li Hongyang

机构信息

Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

J Ophthalmol. 2017;2017:4169135. doi: 10.1155/2017/4169135. Epub 2017 Dec 10.

Abstract

OBJECTIVES

To assess the underlying mechanisms of OIS and confirm the haemodynamic and retinal structure changes of early OIS.

METHODS

An observational cross-sectional study was conducted of 60 internal carotid artery (ICA) stenosis patients, and they were divided into OIS and control group. Colour doppler imaging, optical coherence tomography, and fundus fluorescein angiography were performed.

RESULTS

The middle cerebral artery (MCA) stenosis differs significantly between the two groups. More OIS patients had new collateral patency of posterior communicating artery (PCoA) and retrograde flow via the ophthalmic artery (OA) ( < 0.001). The peak systolic velocity (PSV) in central retinal artery (CRA) and choroidal thickness (CT) was significantly reduced in OIS patients ( = 0.001 and < 0.001). The arm-retina time (ART) and the retinal arteriovenous passage time (AVP) were prolonged in OIS patients ( < 0.001 and = 0.001). CT, ART, and PSV of the CRA showed high sensitivity, while ART and ICA stenosis grade showed high specificity for the diagnosis of OIS according to ROC curve.

CONCLUSIONS

Patients who suffered from severe ipsilateral ICA stenosis, new collateral patency of PCoAs, and MCA stenosis may be more susceptible to OIS. The most sensitive sign is PSV of CRA and CT, and the most specific sign is ART.

摘要

目的

评估眼缺血综合征(OIS)的潜在机制,并确认早期OIS的血流动力学和视网膜结构变化。

方法

对60例颈内动脉(ICA)狭窄患者进行了一项观察性横断面研究,并将他们分为OIS组和对照组。进行了彩色多普勒成像、光学相干断层扫描和眼底荧光血管造影。

结果

两组之间大脑中动脉(MCA)狭窄存在显著差异。更多的OIS患者出现后交通动脉(PCoA)新的侧支循环开放以及通过眼动脉(OA)的逆行血流(<0.001)。OIS患者视网膜中央动脉(CRA)的收缩期峰值速度(PSV)和脉络膜厚度(CT)显著降低(=0.001和<0.001)。OIS患者的臂-视网膜时间(ART)和视网膜动静脉通过时间(AVP)延长(<0.001和=0.001)。根据ROC曲线,CRA的CT、ART和PSV对OIS诊断具有高敏感性,而ART和ICA狭窄分级对OIS诊断具有高特异性。

结论

患有严重同侧ICA狭窄、PCoA新的侧支循环开放和MCA狭窄的患者可能更容易发生OIS。最敏感的体征是CRA的PSV和CT,最特异的体征是ART。

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