Knabben H, Wolf S, Solbach U, Bertram B
Augenklinik der Med. Fak., RWTH Aachen.
Klin Monbl Augenheilkd. 1996 Mar;208(3):142-4. doi: 10.1055/s-2008-1035187.
In the diagnosis of retinal and cerebral vascular occlusion and migraine amaurosis fugax may be an important symptom. To evaluate the relation between cardiovascular diseases and amaurosis fugax we investigated the risk factors in patients with amaurosis fugax.
Twenty-four patients (14 m, 10 f; aged 22 to 84 years; mean: 55 +/- 19 years) with amaurosis fugax were included in this study. All patients underwent a detailed clinical and ophthalmological examination, including video fluorescein angiography shortly after the event.
The duration of symptoms ranged from 30 seconds to 30 minutes (median: 3 minutes). Additional acute symptoms were headache in eight patients and tinnitus in one patient. Visual acuity showed no difference between the effected and the fellow eye. Intraocular pressure was normal in all eyes. Video fluorescein angiography revealed normal retinal perfusion times in all cases (arm-retina-time: 12.9 +/- 3.8 s; arteriovenous passage time: 1.8 +/- 0.7 s). Cardiovascular risk factors were present in all patients: 58% of the patients suffered from arterial hypertension, 8% of the patients from diabetes mellitus. Hyperlipidaemia was diagnosed in 17% of the patients, 46% of the patients were smokers. A history of cardiovascular disease (e.g. myocardial infarction, vitium, arrhythmia) was found in 58% of the patients. Cerebrovascular disease was diagnosed in 54% of the patients (migraine: 33%).
The ophthalmologic examination especially the fluorescein angiography revealed no pathologic findings in patients with amaurosis fugax. The risk factor distribution corresponded to data found in patients with retinal artery occlusion.
在视网膜和脑血管闭塞的诊断中,一过性黑矇可能是一个重要症状。为评估心血管疾病与一过性黑矇之间的关系,我们对一过性黑矇患者的危险因素进行了调查。
本研究纳入了24例一过性黑矇患者(男性14例,女性10例;年龄22至84岁;平均:55±19岁)。所有患者均接受了详细的临床和眼科检查,包括在发病后不久进行的视频荧光血管造影。
症状持续时间为30秒至30分钟(中位数:3分钟)。另外8例患者出现急性头痛,1例患者出现耳鸣。患眼与对侧眼的视力无差异。所有眼的眼压均正常。视频荧光血管造影显示所有病例的视网膜灌注时间均正常(臂-视网膜时间:12.9±3.8秒;动静脉通过时间:1.8±0.7秒)。所有患者均存在心血管危险因素:58%的患者患有动脉高血压,8%的患者患有糖尿病。17%的患者被诊断为高脂血症,46%的患者吸烟。58%的患者有心血管疾病史(如心肌梗死、心脏瓣膜病、心律失常)。54%的患者被诊断为脑血管疾病(偏头痛:33%)。
眼科检查尤其是荧光血管造影在一过性黑矇患者中未发现病理改变。危险因素分布与视网膜动脉阻塞患者的数据相符。