中华眼底病杂志

中华眼底病杂志

颈内动脉重度狭窄患者脉络膜血流及形态结构观察

查看全文

目的 观察颈内动脉重度狭窄患者脉络膜血流及形态结构。 方法 回顾性病例对照研究。临床检查确诊的46例颈内动脉狭窄患者46只眼纳入研究。患者一侧颈内动脉为重度狭窄;对侧颈内动脉为轻度狭窄或无狭窄。将颈内动脉重度狭窄侧眼设为病例组,颈内动脉轻度狭窄或无狭窄侧眼设为对照组,各为46只眼。采用彩色多普勒超声血流成像测量受检眼眼动脉(OA)、睫状后动脉(PCA)收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、博动指数(PI)。采用光相干断层扫描增强深度成像技术测量黄斑中心凹下脉络膜厚度(SFCT);图像二值化处理后测量脉络膜总面积(TCA)、脉络膜血管区(LA)、脉络膜基质区(SA)、脉络膜血管指数(CVI)。对比观察两组受检眼OA、PCA血流动力学指标和SFCT、脉络膜指数变化情况。 结果 病例组受检眼OA及PCA PSV明显低于对照组,差异有统计学意义(t=−2.200、−2.612,P=0.030、0.011)。两组受检眼OA及PCA EDV、RI、PI比较,差异均无统计学意义(OA:t=0.337、−1.810、−1.848,P=0.737、0.074、0.068;PCA:t=−1.160、1.400、0.815,P=0.249、0.165、0.417)。病例组受检眼SFCT(t=−3.711,P<0.001)、TCA(t=−2.736,P=0.007)、LA(t=−3.188,P=0.002)、CVI(t=−2.096,P=0.039)明显低于对照组,差异有统计学意义。两组受检眼SA(t=−1.262,P=0.210)、LA/SA(t=−1.696,P=0.093)比较,差异均无统计学意义。 结论 颈内动脉重度狭窄眼PCA PSV下降;SFCT、TCA、LA、CVI降低。

Objective To observe the choroidal blood flow and morphological changes in patients with severe stenosis of internal carotid artery stenosis (ICAS). Methods A retrospective case-control study. Forty-six patients (46 eyes) with ICAS were enrolled in this study. There was severe stenosis in one side (the eyes in this side were set as case group) and mild or no stenosis in other side (the eyes in this side were set as control group). Color doppler ultrasound (CDI) was used to observe the changes of hemodynamic parameters of the ophthalmic artery (OA) and posterior ciliary artery (PCA), the main parameters of ultrasound Doppler imaging are peak systolic velocity (PSV), end diastolic velocity (EDV), resistance indices (RI) and the calculation of the pulsation indices (PI) through the use of a formula. Enhanced binarization of deep imaging coherence tomography (EDI-OCT) was used to measure the subfoveal choroidal thickness (SFCT). The total subfoveal choroidal area (TCA), luminal (LA), stromal (SA) and choroidal vascularity index (CVI) were obtained by modified image binarization technique. Results In the case group, the PSV in the OA and PCA was significantly lower than that of the control group (t=−2.200, −2.612; P=0.030, 0.011). There were no significant differences in EDV, RI, PI of OA (t=0.337, −1.810, −1.848; P=0.737, 0.074, 0.068) and PCA (t=−1.160, 1.400, 0.815; P=0.249, 0.165, 0.417). The SFCT (t=−3.711, P<0.001), TCA (t=−2.736, P=0.007), LA (t=−3.188, P=0.002) and CVI (t=−2.096, P=0.039) of the case group was significantly lower than that of the control group. There were no significant differences in SA (t=−1.262, P=0.210) and LA/SA (t=−1.696, P=0.093). Conclusion In severe stenosis ICAS eyes, the PSV in the PCA and SFCT, TCA, LA, CVI are decreased.

关键词: 颈动脉狭窄; 脉络膜; 局部血流; 体层摄影术,光学相干; 超声检查,多普勒,彩色

Key words: Carotid stenosis; Choroid; Regional blood flow; Tomography, optical coherence; Ultrasonography, Doppler, color

引用本文: 王惠, 李红阳, 赵露, 陈曦, 郭笑霄, 孙姣, 王艳玲, 尤冉. 颈内动脉重度狭窄患者脉络膜血流及形态结构观察. 中华眼底病杂志, 2018, 34(1): 29-33. doi: 10.3760/cma.j.issn.1005-1015.2018.01.008 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Barteselli G, Lee SN, El-Emam S, et al. Macular choroidal volume variations in highly myopic eyes with myopic traction maculopathy and choroidal neovascularization[J]. Retina, 2014, 34(5): 880-889. DOI: 10.1097/IAE.0000000000000015.
2. Ouyang Y, Heussen FM, Mokwa N, et al. Spatial distribution of posterior pole choroidal thickness by spectral domain optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2011, 52: 7019-7026. DOI: 10.1167/iovs.11-8046.
3. Nishide T, Hayakawa N, Nakanishi M, et al. Reduction in choroidal thickness of macular area in polypoidal choroidal vasculopathy patients after intravitreal ranibizumab therapy[J]. Graefe's Arch Clin Exp Ophthalmol, 2013, 251(10): 2415-2420. DOI: 10.1007/s00417-013-2419-z.
4. Sonoda S, Sakamoto T, Yamashita T, et al. Luminal and stromal areas of choroid determined by binarization method of optical coherence tomographic images[J]. Am J Ophthalmol, 2015, 159(6): 1123-1131. DOI: 10.1016/j.ajo.2015.03.005.
5. Agrawal R, Gupta P, Tan KA, et al. Choroidal vascularity index as a measure of vascular status of the choroid: Measurements in healthy eyes from a population-based study[J]. Sci Rep, 2016, 6: 21090. DOI: 10.1038/srep21090.
6. Agrawal R, Salman M, Tan KA, et al. Choroidal vascularity index (CVI): a novel optical coherence tomography parameter for monitoring patients with panuveitis?[J/OL]. PLoS One, 2016, 11(1): 0146344[2016-01-11]. https://doi.org/10.1371/journal.pone.0146344. DOI: 10.1371/journal.pone.0146344.
7. Agrawal R, Chhablani J, Tan KA, et al. Choroidal vascularity index in central serous chorioretinopathy[J]. Retina, 2016, 36(9): 1646-1651. DOI: 10.1097/IAE.0000000000001040.
8. Gupta P, Jing T, Marziliano P, et al. Distribution and determinants of choroidal thickness and volume using automated segmentation software in a population-based study[J]. Am J Ophthalmol, 2015, 159(2): 293-301. DOI: 10.1016/j.ajo.2014.10.034.
9. Wei X,Ting DSW,Ng WY,et al.Choroidal vascularity index: a novel optical coherence tomography based parameter in patients with exudative age-related macular degeneration[J].Retina,2017, 37(6):1120-1125. DOI: 10.1097/IAE.0000000000001312.
10. Koh LHL, Agrawal R, Khandelwal N, et al. Choroidal vascular changes in age-related macular degeneration[J]. Acta Ophthalmol, 2017, 95(7): 597-601. DOI: 10.1111/aos.13399.
11. Agrawal R, Li LKH, Nakhate V, et al. Choroidal vascularity index in vogt-koyanagi-harada disease: an EDI-OCT derived tool for monitoring disease progression[J]. Transl Vis Sci Technol, 2016, 5(4): 7. DOI: 10.1167/tvst.5.4.7.
12. Lawrence PF, Oderich GS. Ophthalmologic findings as predictors of carotid artery disease[J]. Vasc Endovascular Surg, 2002, 36(6): 415-424. DOI: 10.1177/153857440203600602.
13. 冯雪艳, 叶存喜, 牟明春, 等.一过性黑矇球后血管血流动力学特点及颈动脉彩色多普勒超声特征相关分析[J]. 中华眼科杂志, 2014, 50(6): 421-425. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.005.Feng XY, Ye CX, Mu MC, et al. Correlation analysis on retrobulbar vascular hemodynamic characteristics and carotid artery color Doppler ultrasonographic features of amaurosis fugax[J]. Chin J Ophthalmol, 2014, 50(6): 421-425. DOI: 10.3760/cma.j.issn.0412-4081.2014.06.005.
14. Kang HM, Lee CS, Lee SC. Thinner subfoveal choroidal thickness in eyes with ocular ischemic syndrome than in unaffected contralateral eyes[J]. Graefe's Arch Clin Exp Ophthalmol, 2014, 252(5): 851-852. DOI: 10.1007/s00417-014-2609-3.
15. Kim DY, Joe SG, Lee JY, et al. Choroidal thickness in eyes with unilateral ocular ischemic syndrome[J/OL].J Ophthalmol, 2015, 2015: 620372[2015-10-04]. http://dx.doi.org/10.1155/2015/620372. DOI: 10.1155/2015/620372.
16. Akçay Bİ, Kardeş E, Maçin S, et al. Evaluation of subfoveal choroidal thickness in internal carotid artery stenosis[J/OL]. J Ophthalmol, 2016, 2016: 5296048[2016-02-18]. http://dx.doi.org/10.1155/2016/5296048. DOI: 10.1155/2016/5296048.
17. Branchini LA, Adhi M, Regatieri CV, et al. Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography[J]. Ophthalmology, 2013, 120(9): 1901-1908. DOI: 10.1016/j.ophtha.2013.01.066.
18. Sonoda S, Sakamoto T, Yamashita T, et al. Choroidal structure in normal eyes and after photodynamic therapy determined by binarization of optical coherence tomographic images[J]. Invest Ophthalmol Vis Sci, 2014, 55(6): 3893-3899. DOI: 10.1167/iovs.14-14447.
19. Tan KA, Laude A, Yip V, et al. Choroidal vascularity index - a novel optical coherence tomography parameter for disease monitoring in diabetes mellitus?[J]. Acta Ophthalmol, 2016, 94(7): 612-616. DOI: 10.1111/aos.13044.