Hou Yanli, Tang Simeng, Meng Zhaoyang, Zhao Yingying, Li Jing, Li Hongyang, Wang Yanling
Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Int Ophthalmol. 2025 May 3;45(1):161. doi: 10.1007/s10792-025-03537-y.
To evaluate the incidence of ocular ischemic syndrome (OIS) in patients with asymptomatic Severe Internal Carotid Artery Stenosis or occluded (ipICA-SO).
260 patients with ipICA stenosis ≥ 70%, 120 patients with ipsilateral OIS, and 140 with normal ocular condition. The logistic regression analysis was conducted to establish risk prediction models of OIS/Neovascular-OIS/Chronic-OIS for patients with ipICA-SO. The area under the receiver operating characteristic curve (AUC) was used to test the application value of the prediction models.
In ipICA-SO patients, OIS patients showed significantly higher incidence of ipICA occlusion (p < 0.001), plaque unstable (p < 0.001 ipsilateral/contralateral) or plaque located at both the primary and siphon section (p = 0.004 in ipsilateral), contralateral ICA or anterior/middle cerebral artery severe stenosis (p = 0.001, 0.016, 0.040, respectively), and ipsilateral OphAr low /reflux blood flow (p < 0.001). The hypertension was significantly higher in the control group (p = 0.002). The AUC of the prediction model of OIS was 0.834. Diabetes mellitus (DM) and OphAr reflux blood flow are risk factors for Neovascular-OIS. The AUC of Neovascular-OIS was 0.724. Chronic progress is likely in OIS patients with ipICA occlusion and DM. The AUC of Chronic-OIS was 0.673.
The ipICA-SO patients without sufficient collateral flow are more likely to develop OIS. IpICA-SO patients with hypertension had a lower risk of developing OIS. Neovascular was commonly found in OIS patients with DM and reversed OphAr blood flow. Chronic OIS was associated with ipICA total occlude and DM.
评估无症状性严重颈内动脉狭窄或闭塞（ipICA - SO）患者眼部缺血综合征（OIS）的发生率。
260例ipICA狭窄≥70%的患者，其中120例患有同侧OIS，140例眼部状况正常。进行逻辑回归分析以建立ipICA - SO患者发生OIS/新生血管性OIS/慢性OIS的风险预测模型。采用受试者工作特征曲线下面积（AUC）来检验预测模型的应用价值。
在ipICA - SO患者中，OIS患者的ipICA闭塞发生率显著更高（p < 0.001），斑块不稳定（同侧/对侧，p < 0.001）或斑块位于颈内动脉起始段和虹吸段（同侧，p = 0.004），对侧颈内动脉或大脑前/中动脉严重狭窄（分别为p = 0.001、0.016、0.040），以及同侧眼动脉低血流/反流（p < 0.001）。对照组高血压发生率显著更高（p = 0.002）。OIS预测模型的AUC为0.834。糖尿病（DM）和眼动脉反流是新生血管性OIS的危险因素。新生血管性OIS的AUC为0.724。ipICA闭塞且患有DM的OIS患者可能出现慢性进展。慢性OIS的AUC为0.673。
collateral flow不足的ipICA - SO患者更易发生OIS。患有高血压的ipICA - SO患者发生OIS的风险较低。DM和眼动脉血流反向的OIS患者中常见新生血管。慢性OIS与ipICA完全闭塞和DM相关。 （注：原文中“collateral flow”未明确中文释义，可能需要结合专业知识进一步确定准确中文表述，这里暂保留英文）
