Michelson E L, Morganroth J, Nichols C W, MacVaugh H
Arch Intern Med. 1979 Oct;139(10):1139-41.
Funduscopic examination was performed in 70 non diabetic, nonhypertensive patients without valvular heart disease undergoing coronary angiography for evaluation of chest pain syndromes to determine if retinal arteriolar changes could reliably predict presence of coronary artery disease. Retinal arteriolar changes were graded with respect to light reflex, vessel caliber, arteriovenous crossing defects, and vessel tortuosity without knowledge of angiographic findings. Each coronary vessel was graded with respect to its most occlusive lesion by angiography; coronary index was derived for each patient without knowledge of eye findings. Abnormal light reflex changes were the most sensitive indicators of presence and extent of coronary artery disease. Abnormal vessel tortuosity and decreased caliber were less sensitive but more specific; their presence also suggested more extensive coronary lesions. Thus, funduscopic examination demonstrating specific retinal arteriolar lesions may indicate presence of coronary artery disease and may correlate with extent of lesions in selected patients.
对70例无糖尿病、无高血压且无瓣膜性心脏病的患者进行了眼底检查，这些患者因胸痛综合征接受冠状动脉造影以评估病情，目的是确定视网膜小动脉变化是否能可靠地预测冠状动脉疾病的存在。在不知道血管造影结果的情况下，根据光反射、血管管径、动静脉交叉处病变和血管迂曲度对视网膜小动脉变化进行分级。通过血管造影对每条冠状动脉的最严重闭塞性病变进行分级；在不知道眼部检查结果的情况下为每位患者计算冠状动脉指数。光反射异常变化是冠状动脉疾病存在和程度的最敏感指标。血管迂曲异常和管径减小敏感性较低但特异性较高；它们的存在也提示冠状动脉病变更广泛。因此，眼底检查显示特定的视网膜小动脉病变可能提示冠状动脉疾病的存在，并且可能与部分患者的病变程度相关。
