Advanced Eye Centre, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Retina. 2019 Jun;39(6):1142-1148. doi: 10.1097/IAE.0000000000002103.
To evaluate the outcome of endovascular procedures on ocular findings in patients with Takayasu arteritis.
Retrospective study of patients who underwent percutaneous endovascular stenting of aortic arch arteries for Takayasu arteritis (TA) and who had documented retinopathy findings before and after the procedure. Change in visual acuity, regression of retinopathy, and development of complications after endovascular procedure were studied over a follow-up of 6 months.
Ten eyes of five patients were included. Eyes which had Stage II or less of retinopathy before the endovascular procedure had favorable outcome; however, those with advanced stage of retinopathy at presentation had poor outcomes. Patients who underwent revascularization of both-sided arteries within 1 month had better anatomical and functional outcomes as compared with those who underwent sequential endovascular procedures on their arteries after a gap of 3 months or more.
Percutaneous endovascular stenting of aortic arch arteries, affected in TA, can lead to reversal of retinopathy changes and restoration of vision if done before neovascular complications set in.
评估血管内介入治疗对大动脉炎患者眼部表现的疗效。
回顾性研究了 5 例接受经皮主动脉弓血管腔内支架置入术治疗大动脉炎(TA)且术前有明确视网膜病变的患者。对患者术后 6 个月的视力变化、视网膜病变消退情况和血管内介入治疗后并发症的发生情况进行了研究。
共纳入 5 例患者的 10 只眼。在血管内介入治疗前视网膜病变处于 II 期或更轻阶段的眼预后较好;然而,在就诊时即有晚期视网膜病变的眼预后较差。与血管内介入治疗间隔 3 个月或更长时间的患者相比,在 1 个月内对双侧血管进行血运重建的患者在解剖和功能方面的结果更好。
如果在新生血管并发症发生之前对大动脉炎累及的主动脉弓血管进行经皮血管内支架置入术,可逆转视网膜病变变化并恢复视力。