Benning H, Lieb W, Kahaly G, Grehn F
Augenklinik und Poliklinik, Universität Mainz.
Ophthalmologe. 1994 Feb;91(1):20-5.
Color Doppler imaging makes it possible for the first time to assess the blood flow velocity of orbital vessels. Especially in Graves disease, with its increase of orbital contents, this technique allows detection of changes in the perfusion of retrobulbar arteries and veins. We examined 23 patients (19 female, 4 male, average age 47.9 years) with thyroid ophthalmopathy using color Doppler imaging. Central retinal artery and vein, posterior ciliary arteries, vortex veins, superior orbital vein and ophthalmic artery were located and their Doppler spectra analysed. Results were compared with observations recorded in a control group consisting of 105 healthy volunteers. The thicknesses of extraocular muscles were measured echographically.
There was no significant difference in blood flow velocity in central retinal artery and vein, posterior ciliary arteries and vortex veins between patients with Graves disease and the control group. The maximal blood flow velocity in superior orbital vein was significantly decreased (P = 0.01 on right eye, P = 0.04 on left eye). There was a slight correlation between reduced venous outflow in the superior orbital vein and the severity of the disease (r = 0.52 on right eye, r = 0.5 on left eye).
Color Doppler imaging is a new, noninvasive technique that could be used to examine patients with thyroid ophthalmopathy. Reduced venous outflow may contribute to exophthalmus by creating perivenous edema and consequent swelling of orbital fat.
彩色多普勒成像首次使评估眼眶血管的血流速度成为可能。特别是在格雷夫斯病中,由于眼眶内容物增加,这项技术能够检测球后动静脉灌注的变化。我们使用彩色多普勒成像检查了23例甲状腺眼病患者(19例女性,4例男性,平均年龄47.9岁)。定位视网膜中央动静脉、睫状后动脉、涡静脉、眶上静脉和眼动脉,并分析其多普勒频谱。将结果与由105名健康志愿者组成的对照组的观察结果进行比较。通过超声测量眼外肌厚度。
格雷雷格雷夫斯病患者与对照组在视网膜中央动静脉、睫状后动脉和涡静脉的血流速度上无显著差异。眶上静脉的最大血流速度显著降低(右眼P = 0.01,左眼P = 0.04)。眶上静脉血流减少与疾病严重程度之间存在轻微相关性(右眼r = 0.52,左眼r = 0.5)。
彩色多普勒成像是一种可用于检查甲状腺眼病患者的新型无创技术。静脉流出减少可能通过引起静脉周围水肿和随之而来的眶脂肪肿胀导致眼球突出。