Turan-Vural Ece, Vural Unsal
Ophthalmology Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Cardiovascular Surgery Clinic, Siyami Ersek Training and Research Hospital, Istanbul, Turkey.
Clin Ophthalmol. 2020 Jun 17;14:1641-1650. doi: 10.2147/OPTH.S237403. eCollection 2020.
In this study, it aims to investigate the effect of asymptomatic carotid artery stenosis on peripapillary and subfoveal choroid thickness using enhanced depth imaging optical coherence tomography.
While investigating for coronary artery disease, 76 patients with asymptomatic carotid artery stenosis and 35 patients with normal carotid artery (total = 111) were evaluated. Patients according to the degree of stenosis were divided into four categories as non-stenosis (n = 35), mild (n = 26), moderate (n = 27) and severe stenosis (n = 23). Subfoveal and peripapillary choroid thickness, ocular perfusion and intraocular pressures of all patients were measured using a Fourier-domain optical coherence tomography after general ophthalmological examination. In addition, hypertension, hyperlipidemia, and whether there is a relationship between smoking status and choroid thickness was compared.
As the degree of carotid artery stenosis increased, subfoveal and peripapillary choroidal thickness decreased significantly. However, no changes were detected in ocular perfusion and intraocular pressure values (p=0.935, p=0.519). Decrease in peripapillary and subfoveal choroid thickness values was found to be particularly between the group with severe stenosis and the group with control and mild stenosis (p = 0.003, p = 0.001). In addition, as the degree of carotid stenosis increased in patients with hypertension and smoking, peripapillary choroid thickness was found to be thinner (p=0.003).
We believe that the possibility of carotid artery stenosis should be considered in cases with decreased choroid thickness. In addition, we think that even if it is asymptomatic, in cases with severe carotid stenosis, in the presence of choroidal thinning, a chance of surgical intervention should be given to the stenosis.
本研究旨在利用增强深度成像光学相干断层扫描技术，探讨无症状性颈动脉狭窄对视乳头周围及黄斑中心凹下脉络膜厚度的影响。
在对冠状动脉疾病进行检查时，对76例无症状性颈动脉狭窄患者和35例颈动脉正常患者（共111例）进行了评估。根据狭窄程度将患者分为四类：无狭窄（n = 35）、轻度（n = 26）、中度（n = 27）和重度狭窄（n = 23）。在进行全面眼科检查后，使用傅里叶域光学相干断层扫描测量所有患者的黄斑中心凹下和视乳头周围脉络膜厚度、眼部灌注和眼压。此外，比较了高血压、高脂血症以及吸烟状况与脉络膜厚度之间是否存在关联。
随着颈动脉狭窄程度的增加，黄斑中心凹下和视乳头周围脉络膜厚度显著降低。然而，眼部灌注和眼压值未发现变化（p = 0.935，p = 0.519）。发现视乳头周围和黄斑中心凹下脉络膜厚度值的降低尤其在重度狭窄组与对照组和轻度狭窄组之间（p = 0.003，p = 0.001）。此外，在高血压和吸烟患者中随着颈动脉狭窄程度的增加，视乳头周围脉络膜厚度变薄（p = 0.003）。
我们认为，在脉络膜厚度降低的病例中应考虑颈动脉狭窄的可能性。此外，我们认为即使无症状，在重度颈动脉狭窄且存在脉络膜变薄的情况下，应对狭窄给予手术干预的机会。
