Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Pancreatology. 2020 Dec;20(8):1604-1610. doi: 10.1016/j.pan.2020.10.037. Epub 2020 Oct 11.
There is paucity of data on ocular changes in acute Pancreatitis (AP). Moreover, subclinical alterations in retina & choroid have not been studied in AP.
To prospectively study retino-choroidal changes in AP.
Sixty patients (mean age 39.07 years; 41 males) with AP were followed up till recovery/death. Baseline slit-lamp examination, choroidal thickness (CT), retinal thickness (RT), choroidal vascularity index (CVI), retinal capillary density index (CDI) and arteriovenous ratio (AVR) were recorded. The patients were divided into two groups - mild (Group A; 5 patients) and moderately severe/severe (Group B; 55 patients) as per revised Atlanta classification.
Fundus examination showed mild optic disc edema with retinal hemorrhages in 6 (10%) patients in group B as compared to none in group A (p = 1.00). None of the patients had Purtscher retinopathy. Mean CT (317 ± 56.29 μm) was increased as compared to normal subjects (278.90 ± 57.84 μm, p = 0.003). The mean CVI (0.62 ± 0.04) was decreased as compared to normal (0.66 ± 0.01, p < 0.0001) as was the mean AVR (0.67 ± 0.03 vs. 0.7 ± 0.02, p < 0.0001). However, the mean RT of subjects with AP (239.68 ± 33.76 μm) was not significantly different compared to the normal subjects 253.17 ± 33.67 µm (p=NS). The mean CDI of superficial and deep plexus were comparable between normal and patients with AP. CT, RT, CVI, AVR and CDI were comparable between group A and group B as well as survivors and non-survivors.
Clinically significant ocular changes are seen infrequently in AP. However, subclinical changes in CT, CVI and AVR are observed in patients with AP compared to normal individuals.
急性胰腺炎（AP）患者的眼部变化数据很少。此外，AP 患者的视网膜和脉络膜的亚临床改变尚未被研究。
前瞻性研究 AP 患者的视网膜脉络膜变化。
对 60 例（平均年龄 39.07 岁，男性 41 例）AP 患者进行随访，直至康复或死亡。记录基线裂隙灯检查、脉络膜厚度（CT）、视网膜厚度（RT）、脉络膜血流指数（CVI）、视网膜毛细血管密度指数（CDI）和动静脉比（AVR）。根据修订后的亚特兰大分类，患者分为轻度（A 组；5 例）和中重度/重度（B 组；55 例）两组。
眼底检查显示，B 组有 6 例（10%）患者有轻度视盘水肿伴视网膜出血，而 A 组无 1 例（p=1.00）。无 1 例患者发生 Purtscher 视网膜病变。与正常对照组（278.90±57.84μm，p=0.003）相比，B 组患者的平均 CT（317±56.29μm）增加。与正常对照组（0.66±0.01）相比，B 组患者的平均 CVI（0.62±0.04）降低（p<0.0001），平均 AVR（0.67±0.03 vs. 0.7±0.02，p<0.0001）也降低。然而，AP 患者的平均 RT（239.68±33.76μm）与正常对照组 253.17±33.67μm 相比差异无统计学意义（p=NS）。正常人和 AP 患者浅层和深层脉络膜的平均 CDI 无显著差异。A 组与 B 组、幸存者与非幸存者的 CT、RT、CVI、AVR 和 CDI 无显著差异。
AP 患者很少出现明显的眼部变化。然而，与正常个体相比，AP 患者的 CT、CVI 和 AVR 存在亚临床变化。
