Atilla H, Zilelioğlu G, Ozdemir H, Atilla S, Isik S
Ankara University, School of Medicine, Department of Ophthalmology, Turkey.
Eur J Ophthalmol. 1997 Jan-Mar;7(1):92-100. doi: 10.1177/112067219700700116.
To evaluate the vascular hemodynamic changes that can be detected with color Doppler imaging (CDI) in diagnosis, differential diagnosis and prognosis of uveitis with different etiologies including Behçet's disease.
Four groups consisting of healthy volunteers, uveitis patients with different etiologies and Behçet's disease patients with and without ocular involvement were examined by CDI. Central retinal artery (CRA), posterior ciliary artery (PCA), ophthalmic artery (OA) and central retinal vein (CRV) flow velocities and vascular resistances were measured prospectively by a radiologist blinded to the presence and etiology of uveitis.
The peak systolic and end-diastolic velocities in CRA and PCA in Behçet's disease with ocular involvement were significantly lower than all other groups (p < 0.001). Peak systolic and end-diastolic velocities in CRA were lower than the control group in Behçet's disease patients without ocular involvement (p < 0.001) but there were no differences in PCA and OA flow velocity (p > 0.05). In the uveitis group, CRA and CRV flow velocities were significantly lower than in the control group (p < 0.001).
According to our results, uveitis in Behçet's disease is associated with significant reductions of CRA and PCA flow velocities when compared with other types of uveitis and healthy subjects. In cases without ocular involvement, CRA flow velocities were lower than the control group, but there were no real differences in the PCA and OA values. This suggests that vasculitic involvement of PCA is more specific to Behçet's disease and occurs later in the course of the disease. The results also suggest that it may be possible to detect and follow hemodynamic changes in Behçet's disease with CDI before clinical findings of ocular involvement become evident.
评估彩色多普勒成像(CDI)在诊断、鉴别诊断及预后判断不同病因(包括白塞病)葡萄膜炎时所能检测到的血管血流动力学变化。
对四组对象进行CDI检查,包括健康志愿者、不同病因的葡萄膜炎患者以及有或无眼部受累的白塞病患者。由一位对葡萄膜炎的存在及病因不知情的放射科医生前瞻性地测量视网膜中央动脉(CRA)、睫状后动脉(PCA)、眼动脉(OA)及视网膜中央静脉(CRV)的血流速度和血管阻力。
有眼部受累的白塞病患者CRA和PCA的收缩期峰值及舒张末期速度显著低于所有其他组(p < 0.001)。无眼部受累的白塞病患者CRA的收缩期峰值及舒张末期速度低于对照组(p < 0.001),但PCA和OA的血流速度无差异(p > 0.05)。在葡萄膜炎组中,CRA和CRV的血流速度显著低于对照组(p < 0.001)。
根据我们的结果,与其他类型的葡萄膜炎及健康受试者相比,白塞病性葡萄膜炎与CRA和PCA血流速度的显著降低相关。在无眼部受累的病例中,CRA血流速度低于对照组,但PCA和OA值无实际差异。这表明PCA的血管炎累及对白塞病更具特异性,且发生在疾病进程的后期。结果还表明,在眼部受累的临床体征明显之前,用CDI检测和跟踪白塞病的血流动力学变化可能是可行的。