Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Department of Cardiology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Photodiagnosis Photodyn Ther. 2023 Jun;42:103540. doi: 10.1016/j.pdpdt.2023.103540. Epub 2023 Mar 25.
To investigate retinal and optic disk microcirculation using optical coherence tomography angiography (OCTA) in order to predict related outcomes based on the SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) score (SS) system in coronary artery disease patients.
104 patients were grouped based on coronary angiography results: 32 chronic coronary syndrome (CCS) patients, 35 acute coronary syndrome (ACS) patients, and 37 healthy controls. The SS system determined atherosclerosis degree and lesion-related mortality risk, followed by scoring as SYNTAX I score (SS-I) and SYNTAX II score (SS-II). Patients were further subdivided into SS-I, SS-II percutaneous coronary intervention (PCI), and SS-II coronary artery by-pass grafting (CABG) groups. Following a thorough ophthalmological examination, an OCTA Angio Retina mode (6 × 6 mm) automatically quantified retinal and optic disk microcirculation.
The mean ages did not differ significantly among groups (p = 0.940). The outer retinal select area varied significantly among groups, with the highest values found in ACS patients (p = 0.040). Despite non-significant differences between SS-I patients and healthy controls, the former had lower capillary plexus vessel densities in all regions and in foveal vessel density 300 μm around foveal avascular zone (FD-300) (p>0.05). Vessel densities were lowest in SS-II PCI≥28.5 patients, particularly in whole (p = 0.034) and parafoveal (p = 0.009) superficial capillary plexus, and in FD-300 (p = 0.019). Vessel densities were lowest in SS-II CABG (p = 0.020), and perifoveal (p = 0.017) deep capillary plexus, and in FD-300 (p = 0.003). The outer retina flow area increased the most in SS-II CABG≥25.1 patients (p = 0.020).
Using OCTA, a non-invasive imaging technique, to assess retinal and optic disk microcirculation appears to have the potential to yield significant clinical results in the early diagnosis or prognosis of cardiovascular diseases.
使用光相干断层扫描血管造影术（OCTA）研究视网膜和视盘微循环，以便根据冠状动脉疾病患者的 PCI 与 TAXUS 和心脏手术（SYNTAX）评分（SS）系统之间的协同作用预测相关结果。
根据冠状动脉造影结果将 104 例患者分组：32 例慢性冠状动脉综合征（CCS）患者、35 例急性冠状动脉综合征（ACS）患者和 37 例健康对照者。SS 系统确定动脉粥样硬化程度和病变相关死亡率风险，然后评分作为 SYNTAX I 评分（SS-I）和 SYNTAX II 评分（SS-II）。患者进一步分为 SS-I、SS-II 经皮冠状动脉介入治疗（PCI）和 SS-II 冠状动脉旁路移植术（CABG）组。进行全面眼科检查后，使用 OCTA Angio Retina 模式（6×6mm）自动量化视网膜和视盘微循环。
各组之间的平均年龄无显著差异（p=0.940）。外视网膜选择区域在各组之间存在显著差异，ACS 患者的数值最高（p=0.040）。尽管 SS-I 患者与健康对照组之间无显著差异，但前者在所有区域和黄斑无血管区 300μm 周围的黄斑区血管密度（FD-300）的毛细血管丛血管密度较低（p>0.05）。SS-II PCI≥28.5 患者的血管密度最低，尤其是全层（p=0.034）和旁黄斑浅层毛细血管丛（p=0.009）以及 FD-300（p=0.019）。SS-II CABG 患者的血管密度最低（p=0.020），包括旁黄斑深层毛细血管丛（p=0.017）和 FD-300（p=0.003）。SS-II CABG≥25.1 患者的外视网膜血流面积增加最多（p=0.020）。
使用 OCTA 这种非侵入性成像技术评估视网膜和视盘微循环似乎有可能在心血管疾病的早期诊断或预后方面产生重要的临床结果。
