Medical Education Department, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK.
NIHR Moorfields Biomedical Research Centre, London, UK.
Heart. 2023 Oct 26;109(22):1670-1676. doi: 10.1136/heartjnl-2022-322081.
The eye is prone to various forms of afflictions, either as a manifestation of primary ocular disease or part of systemic disease, including the cardiovascular system. A thorough cardiovascular examination should include a brief ocular assessment. Hypertension and diabetes, for example, would present with retinopathy and dyslipidaemia would present with corneal arcus. Multisystem autoimmune diseases, such as Graves' disease, rheumatoid arthritis and sarcoidosis, would present with proptosis, episcleritis and scleritis, respectively. Myasthenia gravis, while primarily a neuromuscular disease, presents with fatigable ptosis and is associated with Takotsubo cardiomyopathy and giant cell myocarditis. Connective tissue diseases such as Marfan syndrome, which commonly presents with aortic root dilatation, would be associated with ectopia lentis and myopia. Wilson's disease, which is associated with arrhythmias and cardiomyopathies, would present usually with the characteristic Kayser-Fleischer rings. Rarer diseases, such as Fabry disease, would be accompanied by ocular signs such as cornea verticillata and such cardiac manifestations include cardiac hypertrophy as well as arrhythmias. This review examines the interplay between the eye and the cardiovascular system and emphasises the use of conventional and emerging tools to improve diagnosis, management and prognostication of patients.
眼睛容易受到各种形式的疾病的影响，这些疾病既可以是原发性眼部疾病的表现，也可以是系统性疾病的一部分，包括心血管系统。全面的心血管检查应包括简要的眼部评估。例如，高血压和糖尿病会出现视网膜病变，血脂异常会出现角膜弓。多系统自身免疫性疾病，如格雷夫斯病、类风湿关节炎和结节病，分别会出现眼球突出、表层巩膜炎和巩膜炎。重症肌无力虽然主要是一种神经肌肉疾病，但会出现易疲劳性上睑下垂，并与 Takotsubo 心肌病和巨细胞心肌炎有关。马凡综合征等结缔组织疾病，常见的表现为主动脉根部扩张，会伴有晶状体异位和近视。与心律失常和心肌病有关的威尔逊病通常会出现特征性的凯斯勒-弗莱舍环。更罕见的疾病，如法布里病，会伴有角膜涡旋等眼部表现，以及心脏肥厚和心律失常等心脏表现。本文回顾了眼睛和心血管系统之间的相互作用，并强调了使用传统和新兴工具来改善患者的诊断、管理和预后。
