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比较冠心病患者和有冠心病风险患者的脉络膜厚度。

Comparison of choroidal thicknesses in patients with coronary artery disease and patients at risk of coronary artery disease.

机构信息

Department of Ophthalmology, Fevziçakmak District, Darıca Farabi Training and Research Hospital, Dr. Zeki Acar Street. No: 62, 41700, Darıca, Kocaeli, Turkey.

Department of Cardiology, Darıca Farabi Training and Research Hospital, Darıca, Kocaeli, Turkey.

出版信息

Int Ophthalmol. 2021 Jun;41(6):2117-2124. doi: 10.1007/s10792-021-01769-2. Epub 2021 Mar 16.

Abstract

PURPOSE

The study aimed to compare choroidal thicknesses (CTh) in patients with coronary artery disease (CAD) and patients at risk of coronary artery disease and investigate whether thinning of the choroid can be used as a biomarker for development of coronary artery disease in patients at risk.

MATERIALS AND METHODS

The study group was composed of 103 eyes of 53 patients with coronary artery disease, and the control group was composed of 62 eyes of 32 patients with diabetes mellitus, hypertension and/or hyperlipidemia without coronary artery disease. CAD was diagnosed in patients with one of the following: myocardial infarction with/without ST segment elevation, clinically proven history of cardiac catheterization testifying greater than 50% obstruction in at least one coronary artery, revascularization operations. The control group consisted of clinically proven patients with normal coronary arteries. The choroidal thickness was measured with enhanced depth imaging optical coherence tomography under the fovea and at six other points, located at 500 micron, 1000 micron and 1500 micron nasal to the fovea and 500 micron, 1000 micron, 1500 micron temporal to the fovea.

RESULTS

The subfoveal choroidal thickness was significantly thinner in the coronary artery disease group compared to the control group (244 µm vs. 289 µm; p < 0,001). In all other measured regions (nasal 500, nasal 1000, nasal 1500, temporal 500, temporal 1000, and temporal 1500 micron), CTh was statistically significant thinner in the CAD group. A negative significant linear relationship (low level) between CAD duration and choroidal thickness in the subfoveal, nasal 1000, nasal 1500, temporal 500, temporal 1000 micron regions was detected.

CONCLUSION

Patients with CAD have a decreased choroidal thickness compared to patients at risk of CAD. Detection of CTh thinning in a patient with diseases, such as diabetes, hypertension and/or hypercholesterolemia, which pose a risk for CAD may be a predictor of development of coronary artery disease. Clinical Trials Registration Kocaeli Derince Training and Research Hospital ethics committee-protocol number: 2020-106.

摘要

目的

本研究旨在比较冠心病(CAD)患者和有 CAD 风险患者的脉络膜厚度(CTh),并探讨脉络膜变薄是否可作为有 CAD 风险患者发生 CAD 的生物标志物。

材料与方法

研究组由 53 例 CAD 患者的 103 只眼组成,对照组由 32 例无 CAD 的糖尿病、高血压和/或高脂血症患者的 62 只眼组成。CAD 的诊断标准为:心肌梗死伴/不伴 ST 段抬高、经临床证实的心脏导管术史证明至少一条冠状动脉存在 50%以上阻塞、血运重建术。对照组为经临床证实的正常冠状动脉患者。应用增强深度成像光学相干断层扫描(OCT)在黄斑下及其他 6 个点测量脉络膜厚度,这 6 个点分别位于距黄斑鼻侧 500μm、1000μm 和 1500μm 处,以及距黄斑颞侧 500μm、1000μm 和 1500μm 处。

结果

与对照组相比,CAD 组患者黄斑下脉络膜厚度明显变薄(244μm vs. 289μm;p<0.001)。在所有其他测量区域(鼻侧 500μm、鼻侧 1000μm、鼻侧 1500μm、颞侧 500μm、颞侧 1000μm 和颞侧 1500μm),CAD 组的 CTh 均显著变薄。在黄斑下、鼻侧 1000μm、鼻侧 1500μm、颞侧 500μm、颞侧 1000μm 区域,CAD 持续时间与脉络膜厚度呈负相关(低度相关)。

结论

与有 CAD 风险的患者相比,CAD 患者的脉络膜厚度降低。在糖尿病、高血压和/或高胆固醇血症等有 CAD 风险的疾病患者中检测到 CTh 变薄可能是 CAD 发生的预测指标。

临床试验注册号

Kocaeli Derince Training and Research Hospital ethics committee-protocol number: 2020-106。

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