颈动脉狭窄与视网膜静脉阻塞发生及预后的相关性研究

The correlation research of Carotid artery stenosis with retinal vein occlusion and prognosis

目的探讨颈动脉狭窄与视网膜静脉阻塞患者眼部灌注的相关性,了解颈动脉狭窄在RVO中的发生比率及RVO与颈动脉狭窄程度的关系。方法选取2016年10月至2018年12月本院收治的RVO患者共18例(18眼)作为研究对象,其中BRVO患者10例(10眼),CRVO患者8例(8眼),采用前瞻性研究方法,入组患者均行双眼最佳矫正视力、眼压、裂隙灯、眼底照相/颈动脉超声检查,双眼球后血管超声检查、黄斑区EDI模式OCT检查。结果18例患者中,眼侧颈动脉狭窄16例,患侧和健侧眼的颈动脉狭窄发生率比较差异有统计学意义(P<0.O5)。BRVO和CRVO两组不同程度颈动脉狭窄患者分布比较差异有统计学意义(P<0.05)。患眼和健眼视网膜中央动脉各指标比较,仅内径大小一项差异有统计学意义(P<0.05),患眼侧的视网膜中央动脉内径要低于健眼侧。结论颈动脉狭窄是RVO的致病因素之一,颈动脉狭窄对RVO患者血流影响的解剖层面在于视网膜中央血管层面的可能性大,即视网膜中央动脉的血流改变,有可能导致视网膜中央或分支静脉的瘀滞阻塞。

Objective To investigate the correlation of the carotid stenosis and retinal vein occlusion(RVO)in patients with ocular perfusion,understand the occurrence rate of carotid stenosis in the RVO and the relationship between the degree of carotid stenosis and RVO.Methods 18 patients(18 eyes)with RVO in our hospital from October 2016 to December 2018 were selected as the study subjects,and there were 10 cases(10 eyes)with BRVO and 8 cases(8 eyes)with CRVO.The prospective study method was used.All the patients underwent best corrected visual acuity(BCVA),intraocular pressure(IOP),slit lamp,fundus photography/carotid ultrasound,retrobulbar vascular ultrasound and EDI mode OCT in macular area.Results Among the 18 patients,16 cases had carotid artery stenosis on the ocular side,there was significant difference in the incidence of carotid artery stenosis between the affected side and the healthy side(P<0.05).BRVO and CRVO groups of different degree of carotid stenosis patients distribution,the difference was statistically significant(P<0.05).Only the diameter of the central retinal artery was significantly different between the affected and healthy eyes(P<0.05).The central retinal artery diameter of eye side is lower than the healthy eye side.Conclusion Carotid artery stenosis may be one of the cause of RVO.The anatomic level of the influence of carotid artery stenosis on blood flow of RVO patients lies in the level of central retinal vessels.That is,the blood flow changes of the central retinal artery may lead to the stagnation and obstruction of the central or branch retinal veins.