Sagar S, Kar S, Gupta A, Sharma B K
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Jpn J Ophthalmol. 1994;38(1):97-102.
Twenty-seven patients (ages 13-55 years) with Takayasu's arteritis (TA) underwent a detailed ophthalmological examination which included a history of visual symptoms, recording of visual acuity, slit-lamp examination, examination of retina (direct fundoscopy and rapid sequence fluorescein angiography) and estimation of retinal haemodynamics. Arterial hypertension was the commonest (77%) presentation of TA. Sixty-six percent of the patients had one or more ocular change. Sixteen (33%) of the 54 eyes tested had Takayasu's retinopathy (TR), 20 eyes (37%) had hypertensive retinopathy (HR) and the retina was normal (NR) in 18 eyes (33%). Two patients with advanced TR had bilateral cataract. The arm-to-retina circulation time in eyes with TR (16.4 +/- 2.66 seconds) was prolonged as compared to the eyes with HR (10.9 +/- 1.63 seconds, P < 0.01) and NR (9.6 +/- 2.37 seconds, P < 0.01). The arteriovenous filling time in eyes with TR was also significantly prolonged. The intraocular pressure (mmHg) in eyes with TR (9.3 +/- 3.6) was lower (P < 0.001) than that in eyes with HR (14.4 +/- 4.1 mmHg) and NR (14.2 +/- 2.6). Central retinal artery pressure recorded in 8 eyes with TR was less than 35 mmHg in spite of the systemic hypertension. The retinal haemodynamics suggest that the carotid artery involvement leading to diminished retinal blood flow is the pathogenetic mechanism of TR.
27例（年龄13 - 55岁）大动脉炎（TA）患者接受了详细的眼科检查，包括视觉症状史、视力记录、裂隙灯检查、视网膜检查（直接检眼镜检查和快速序列荧光素血管造影）以及视网膜血流动力学评估。动脉高血压是TA最常见的表现（77%）。66%的患者有一项或多项眼部改变。在接受检查的54只眼中，16只（33%）有大动脉炎视网膜病变（TR），20只眼（37%）有高血压性视网膜病变（HR），18只眼（33%）视网膜正常（NR）。两名晚期TR患者患有双侧白内障。与HR组（10.9±1.63秒，P < 0.01）和NR组（9.6±2.37秒，P < 0.01）相比，TR组眼的臂 - 视网膜循环时间（16.4±2.66秒）延长。TR组眼的动静脉充盈时间也显著延长。TR组眼的眼压（mmHg）（9.3±3.6）低于HR组眼（14.4±4.1 mmHg）和NR组眼（14.2±2.6）（P < 0.001）。尽管存在系统性高血压，但8只患有TR的眼中记录的视网膜中央动脉压低于35 mmHg。视网膜血流动力学表明，颈动脉受累导致视网膜血流减少是TR的发病机制。
