Ghanchi F D, Williamson T H, Lim C S, Butt Z, Baxter G M, McKillop G, O'Brien C
Tennent Institute of Ophthalmology, Western Infirmary, Glasgow, UK.
Eye (Lond). 1996;10 ( Pt 4):459-64. doi: 10.1038/eye.1996.101.
The ophthalmological manifestations of giant cell arteritis (GCA) present a difficult diagnostic and management problem to the ophthalmologist. The orbital circulation is frequently involved in the disease process. The effects of GCA on orbital blood flow assessed by colour Doppler imaging (CDI) were investigated in this study. Serial CDI examinations of the orbital blood vessels were performed (at presentation, 2 days, 1 week and at 1 month) on 7 patients with GCA. CDI examination at presentation was also performed on 4 patients with non-arteritic anterior ischaemic optic neuropathy (AION) for comparison. Blood flow could not be detected in up to three arteries in the affected (ipsilateral) orbit of 6 GCA patients at presentation. Five of these patients were also found to have undetectable blood flow in the posterior ciliary arteries of the contralateral orbit. Serial CDI examination revealed blood flow alterations in arteritic patients despite treatment. Return of blood flow to normal was slow, and related to the clinical features. By contrast, only 1 of the patients with non-arteritic AION showed undetectable blood flow in a posterior ciliary artery. GCA leads to widespread and prolonged alterations in orbital blood flow. CDI allows the detection and monitoring of such alterations in orbital blood flow, which correlate with the clinical features of GCA. Serial CDI examinations in GCA may be used to aid management decisions.
巨细胞动脉炎（GCA）的眼科表现给眼科医生带来了诊断和管理难题。眼眶血液循环在疾病过程中常受累。本研究调查了GCA对通过彩色多普勒成像（CDI）评估的眼眶血流的影响。对7例GCA患者的眼眶血管进行了系列CDI检查（就诊时、2天、1周和1个月时）。还对4例非动脉炎性前部缺血性视神经病变（AION）患者进行了就诊时的CDI检查以作比较。6例GCA患者就诊时在患侧（同侧）眼眶中多达三条动脉检测不到血流。其中5例患者在对侧眼眶的睫状后动脉中也检测不到血流。系列CDI检查显示，尽管进行了治疗，动脉炎患者仍有血流改变。血流恢复正常缓慢，且与临床特征相关。相比之下，非动脉炎性AION患者中只有1例在睫状后动脉中检测不到血流。GCA导致眼眶血流广泛且长期改变。CDI可检测和监测眼眶血流的此类改变，这些改变与GCA的临床特征相关。GCA患者的系列CDI检查可用于辅助管理决策。
