脉络膜脱离型视网膜脱离患者眼部血流动力学研究

Study on the hemodynamics of rhegmatogenous retinal detachment associated with choroidal detachment

目的通过分析脉络膜脱离型视网膜脱离(RRDCD)患者的眼部血流动力学参数,探究眼血流是否参与RRDCD的发生。方法回顾性病例对照研究。选取60名研究对象入组,其中RRDCD患者30例,孔源性视网膜脱离(RRD)患者30例,用彩色多普勒超声测量患者患眼和健康眼的眼动脉(OR)、睫状后动脉(PCA)和视网膜中央动脉(CRA)的血流参数,并收集以上患者的临床资料和详细的眼科检查结果。将患者分为RRD组和RRD对侧眼组,RRDCD组和RRDCD对侧眼组,分析RRDCD的临床特征,并对患者的基线资料及临床参数比较。再分析比较各组眼血流参数。采用SPSS 23.0统计学软件进行统计分析,以P<0.05为差异有统计学意义。结果RRD组患者患眼与对侧眼相比OA、CRA的峰值收缩速度(PSV)和舒张末期速度(EDV)降低(P<0.05)。RRDCD组患者患眼与对侧眼相比,眼压明显降低,CRA和PCA的PSV和EDV降低(P<0.05)。RRDCD组患眼和RRD组患眼相比,RRDCD组患眼PCA的阻力指数(RI)降低(P<0.05)。结论RRD患者患眼OA、CRA血流速度降低,RRDCD患眼CRA、PCA血流速度明显降低;PCA血流供应减少可能解释了RD并发脉络膜脱离的原因。

Objective To investigated whether ocular blood flow was involved in the occurrence of RRDCD by analyzing ocular hemodynamic in patients with retinal detachment.Methods We collected 30 patients diagnosed as RRD and 30 patients diagnosed as RRDCD from October 2020 to December 2021 in the First Affiliated Hospital of Xinjiang Medical University.Color Doppler ultrasound was used to measure the blood flow parameters of ophthalmic artery,middle retinal artery and posterior ciliary artery in patients'eyes and healthy eyes.We also collected the clinical data and detailed ophthalmic examination results of the above patients.The patients were divided into RD group and RD contralateral eye group,RRD group and RRD contralateral eye group,RRDCD group and RRDCD contralateral eye group.The clinical features of patients with RRDCD were analyzed,and the baseline data and clinical parameters were compared.The blood flow parameters of each group were analyzed and contrasted Statistical analysis was performed applying SPSS 23.0 statistical software,and the difference was statistically significant if P<0.05.Results Compared with the contralateral eye,PSV and EDV of the OA,CRA and PCA in the affected eye of people with retinal detachment were decreased,and the RI was increased(P<0.05).Compared with the contralateral eye,the intraocular pressure of the affected eye of patients with RRDCD was significantly decreased,and the PSV and EDV of CRA and PCA were decreased(P<0.05).Statistically significant linear correlations were found between CRA and PCA flow parameters and intraocular pressure.Conclusions In the eyes of RRD,the blood flow velocity of ophthalmic artery and CRA decreased;PCA blood flow velocity is significantly decreased in patients with RRDCD;The decrease of PCA blood flow may explain why patients with retinal detachment accompanied by choroidal detachment.