Department of Ophthalmology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, 200030, China.
Sci Rep. 2024 Feb 24;14(1):4552. doi: 10.1038/s41598-023-50283-1.
Myocardial infarction is defined as a sudden decrease or interruption in blood flow to the coronary arteries, causing ischemic necrosis of the corresponding cardiomyocytes. It is unclear whether systemic macrovascular alterations are associated with retinal microvascular changes. This study utilized optical coherence tomography angiography (OCTA) to compare variations in conjunctival vascular density and fundus retinal vessel density between patients with myocardial infarction (MI) and healthy controls. This study recruited 16 patients (32 eyes) with MI and 16 healthy controls (32 eyes). The superficial retinal layer (SRL), deep retinal layer (DRL) and conjunctival capillary plexus in each eye were evaluated by OCTA. Parameters measured included the density of the temporal conjunctival capillary, retinal microvascular (MIR) and macrovascular (MAR) alterations and total MIR (TMI). The microvascular density of each retinal region was evaluated by the hemisphere segmentation (SR, SL, IL, and IR), annular partition (C1, C2, C3, C4, C5 and C6), and modified early treatment of diabetic retinopathy study (R, S, L, and I) methods. In the macular area, the superficial and deep retinal microvascular densities displayed notable variations. In the superficial layers, the superficial TMI, superficial MIR, and superficial MAR, as well as densities in the SL, IL, S, L, C1, C2, C5 and C6 regions, were significantly lower in MI patients (p < 0.05 each). In the deep layers, the deep MIR and deep TMI), as well as densities in the SL, IL, L, C1, C2 and C6 regions were significantly lower in MI patients (p < 0.05 each). In contrast, the conjunctival microvascular density was significantly higher in MI patients than in healthy controls (p < 0.001). The microvascular densities measured in the deep and superficial retinal layers and in the conjunctiva differ in MI patients and healthy controls. OCTA is effective in detecting changes in the ocular microcirculation.
心肌梗死定义为冠状动脉血流的突然减少或中断，导致相应的心肌细胞缺血性坏死。目前尚不清楚全身大血管改变是否与视网膜微血管变化有关。本研究采用光学相干断层扫描血管造影术（OCTA）比较心肌梗死（MI）患者与健康对照者结膜血管密度和眼底视网膜血管密度的变化。本研究纳入 16 例 MI 患者（32 只眼）和 16 名健康对照者（32 只眼）。通过 OCTA 评估每只眼的浅层视网膜层（SRL）、深层视网膜层（DRL）和结膜毛细血管丛。测量的参数包括颞侧结膜毛细血管密度、视网膜微血管（MIR）和大血管（MAR）改变以及总 MIR（TMI）。通过半球分割（SR、SL、IL 和 IR）、环形分区（C1、C2、C3、C4、C5 和 C6）和改良早期糖尿病性视网膜病变研究（R、S、L 和 I）方法评估每个视网膜区域的微血管密度。在黄斑区，浅层和深层视网膜微血管密度存在明显差异。在浅层，浅层 TMI、浅层 MIR 和浅层 MAR 以及 SL、IL、S、L、C1、C2、C5 和 C6 区域的密度在 MI 患者中显著降低（p < 0.05 各）。在深层，深层 MIR 和深层 TMI）以及 SL、IL、L、C1、C2 和 C6 区域的密度在 MI 患者中显著降低（p < 0.05 各）。相比之下，MI 患者的结膜微血管密度明显高于健康对照组（p < 0.001）。MI 患者和健康对照组的深层和浅层视网膜层以及结膜的微血管密度存在差异。OCTA 可有效检测眼部微循环的变化。
