Departments of Radiology (ASL, GL, JH, WB), Neurosurgery (GL, WB), Neurology (JJC, MTB, JPK), Ophthalmology (JJC, MTB), Mayo Clinic, Rochester, Minnesota.
J Neuroophthalmol. 2021 Dec 1;41(4):e572-e577. doi: 10.1097/WNO.0000000000001156.
Intraplaque hemorrhage (IPH) in a carotid artery plaque viewed on vessel wall imaging has been shown to be associated with ischemic stroke. Whether such an association between carotid IPH and retinal artery occlusion (RAO) exists remains unknown.
This was a cross-sectional prevalence study. Medical and imaging records of all patients who underwent neck MRA with plaque imaging sequences at our institution from 2015 to 2020 were retrospectively reviewed. Fourteen patients with confirmed RAO and plaque imaging performed within 6 weeks of presentation were included. A group of 211 patients without a prior ischemic event (RAO, stroke, etc.) with plaque imaging were used as controls. A single artery from control patients was randomly selected. The prevalence of IPH and degree of ipsilateral carotid stenosis were compared between RAO and control patients. Multiple regression analysis was performed to determine independent associations between variables and RAO.
Five patients (35.7%) with RAO had imaging evidence of ipsilateral IPH in contrast to 7 of 211 (3.3%) patients in the control group (odds ratio [OR]: 16.2, 95% confidence interval [95% CI]: 4.3-61.1, P = 0.0002). Of the 5 patients with RAO and ipsilateral IPH, only one (20.0%) was found to ipsilateral carotid stenosis greater than 70%. Carotid IPH was the only variable that was independently associated with RAO (OR: 12.6, 95% CI = 2.2-73.6, P = 0.005).
Carotid IPH is independently associated with RAO. The use of plaque imaging in the evaluation of patients with acute RAO is therefore supported.
血管壁成像显示颈动脉斑块内的斑块内出血（IPH）与缺血性中风有关。颈动脉 IPH 与视网膜动脉阻塞（RAO）之间是否存在这种关联尚不清楚。
这是一项横断面患病率研究。回顾性分析了 2015 年至 2020 年在我院行颈部 MRA 并进行斑块成像序列检查的所有患者的医疗和影像学记录。纳入了 14 例经证实的 RAO 患者，且在发病后 6 周内进行了斑块成像。将一组 211 例无既往缺血事件（RAO、中风等）且有斑块成像的患者作为对照组。从对照组中随机选择一条动脉。比较 RAO 患者和对照组患者的 IPH 发生率和同侧颈动脉狭窄程度。采用多元回归分析确定变量与 RAO 之间的独立相关性。
5 例（35.7%）RAO 患者存在同侧 IPH 的影像学证据，而对照组 211 例患者中仅 7 例（3.3%）（优势比[OR]：16.2，95%置信区间[95%CI]：4.3-61.1，P=0.0002）。在 5 例 RAO 合并同侧 IPH 的患者中，仅 1 例（20.0%）同侧颈动脉狭窄>70%。颈动脉 IPH 是唯一与 RAO 独立相关的变量（OR：12.6，95%CI=2.2-73.6，P=0.005）。
颈动脉 IPH 与 RAO 独立相关。因此，在评估急性 RAO 患者时支持使用斑块成像。
