Department of Neurology, Stroke Centre, La Paz University Hospital - IdiPAZ Health Research Institute, Autonoma University of Madrid, Madrid, Spain.
Vasc Med. 2021 Jun;26(3):302-309. doi: 10.1177/1358863X21993214. Epub 2021 Mar 18.
Acute, painless, monocular vision loss (APMVL) usually has a vascular aetiology. We conducted a prospective observational study from 2011 to 2018 to analyse the added value of colour Doppler imaging to assess orbital vessel blood flow in the diagnosis of APMVL. The study included 67 patients (39 [58.2%] men; mean age, 65.9 years [SD 13.7]) with APMVL evaluated at the Neurosonology Laboratory within the first 5 days of symptom onset, who were classified as having either transient or persistent monocular blindness. The blood flow in the ophthalmic and central retinal arteries was assessed using colour Doppler ultrasound with a linear 7.5-MHz transducer. Thirty-three (49.3%) patients presented transient monocular blindness, with reduced blood flow in either the ophthalmic or central retinal artery. The group with persistent vision loss included 24 cases of central retinal artery occlusion (CRAO) and 10 cases of ischaemic optic neuropathy (35.8% and 14.9%, respectively, of the total sample). These patients were older and had a higher prevalence of hypertension and mild carotid atherosclerosis. Orbital colour Doppler ultrasound (OCDUS) clarified the mechanism/cause of the ischaemia in 11 (16.4%) patients and showed abnormal flow in 46 (68.7%) patients, confirming the vascular origin in 19 (57.6%) of the transient monocular blindness cases. Lower peak systolic velocity was observed in patients with CRAO ( < 0.001), and a velocity < 10 cm/s in the central retinal artery was independently associated with the diagnosis of CRAO. OCDUS can be helpful in confirming the vascular cause and identifying the aetiology of APMVL.
急性、无痛、单眼视力丧失（APMVL）通常具有血管病因。我们进行了一项前瞻性观察研究，从 2011 年至 2018 年分析彩色多普勒成像在评估眶血管血流中的附加价值，以诊断 APMVL。该研究纳入了 67 名（39 名[58.2%]男性；平均年龄 65.9 岁[SD 13.7]）在症状发作后的前 5 天内于神经超声实验室评估 APMVL 的患者，这些患者分为短暂性或持续性单眼盲。使用线性 7.5MHz 探头的彩色多普勒超声评估眼动脉和视网膜中央动脉的血流。33 名（49.3%）患者表现为短暂性单眼盲，眼动脉或视网膜中央动脉血流减少。持续性视力丧失组包括 24 例视网膜中央动脉阻塞（CRAO）和 10 例缺血性视神经病变（分别占总样本的 35.8%和 14.9%）。这些患者年龄较大，高血压和轻度颈动脉粥样硬化的患病率较高。眼眶彩色多普勒超声（OCDUS）在 11 名（16.4%）患者中阐明了缺血的机制/病因，并在 46 名（68.7%）患者中显示异常血流，在 19 名（57.6%）短暂性单眼盲患者中证实了血管起源。CRAO 患者的收缩期峰值速度较低（<0.001），视网膜中央动脉的速度<10cm/s 与 CRAO 的诊断独立相关。OCDUS 有助于确认血管病因并确定 APMVL 的病因。
