Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophtalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rom J Intern Med. 2021 May 8;59(2):174-179. doi: 10.2478/rjim-2020-0039. Print 2021 Jun 1.
Approximately 10-30% of the patients with typical symptoms of angina pectoris have normal angiography showing normal macrovasculature. In these patients, however, the microvascular problems should be monitored. Hence, the main aim of this study is to evaluate retinal changes in normal angiographic patients. In this descriptive cross-sectional study, 60 normal angiographic patients with typical chest pain or anginal equivalents visiting Modarres Hospital Cardiology Research Center between 2018 and 2019 were enrolled and retinal changes were determined in Labbafinejad Hospital by Optical Coherence Tomography Angiography using Foveal Avascular Zone (FAZ), Superficial Vascular Density (SVD), and Deep Vascular Density (DVD). The results of this study demonstrated that FAZ was normal in all subjects, but SVD and DVD were abnormal in 45% and 8.3%, respectively. Totally, 18.5% and 66.7% showed abnormal SVD among stable angina (SA) and unstable angina (UA) cases, respectively (P < 0.001). There was no statistically significant difference between abnormal DVD in SA and UA cases (P = 0.058). Abnormal SVD was significantly more common among diabetic patients (P < 0.001), while DVD was not related to diabetes presence in the study population (P > 0.05). Moreover, abnormal SVD was more common among patients with chest pain (P = 0.036), while there was no significant difference for DVD (P = 0.371). Interestingly, abnormal ECG was associated with both abnormal DVD and SVD. The results of this study showed that nearly half of the patients with angina pectoris or anginal equivalents who revealed normal angiographic findings may suffer from retinal changes. Thus, retinal assessment is needed in these patients to evaluate microvascular changes.
约 10-30%具有典型心绞痛症状的患者行血管造影检查显示正常大血管。然而，这些患者应监测微血管问题。因此，本研究的主要目的是评估血管造影正常患者的视网膜变化。在这项描述性的横断面研究中，2018 年至 2019 年期间，共有 60 名具有典型胸痛或等效心绞痛的血管造影正常患者在 Modarres 医院心脏病学研究中心就诊，他们在 Labbafinejad 医院通过光学相干断层扫描血管造影（OCTA）确定视网膜变化，使用中心凹无血管区（FAZ）、浅层血管密度（SVD）和深层血管密度（DVD）。研究结果表明，所有受试者的 FAZ 均正常，但 SVD 和 DVD 分别异常 45%和 8.3%。在稳定性心绞痛（SA）和不稳定性心绞痛（UA）患者中，分别有 18.5%和 66.7%的患者 SVD 异常（P < 0.001）。SA 和 UA 患者中 DVD 异常无统计学差异（P = 0.058）。糖尿病患者 SVD 异常更为常见（P < 0.001），而 DVD 与研究人群中糖尿病的存在无关（P > 0.05）。此外，胸痛患者 SVD 异常更为常见（P = 0.036），而 DVD 则无明显差异（P = 0.371）。有趣的是，异常心电图与 DVD 和 SVD 异常均有关。本研究结果表明，近一半具有典型心绞痛或等效心绞痛且血管造影正常的患者可能患有视网膜变化。因此，需要对这些患者进行视网膜评估以评估微血管变化。
