患者女,26岁。因突发右眼视物不清1 d,于2023年4月13日到遵义医科大学第二附属医院眼科就诊。患者半个月前因右侧腘静脉血栓栓塞行下腔静脉滤器置入手术及尿激酶溶栓、那屈肝素钠抗凝治疗。否认其他全身病史。眼科检查:右眼、左眼最佳...患者女,26岁。因突发右眼视物不清1 d,于2023年4月13日到遵义医科大学第二附属医院眼科就诊。患者半个月前因右侧腘静脉血栓栓塞行下腔静脉滤器置入手术及尿激酶溶栓、那屈肝素钠抗凝治疗。否认其他全身病史。眼科检查:右眼、左眼最佳矫正视力分别为数指/10 cm、1.0。右眼、左眼眼压分别为14、11 mm Hg(1 mm Hg=0.133 kPa)。右眼直接对光反射消失。眼底检查,右眼视盘水肿,盘缘小片状出血,视网膜静脉纡曲扩张,“串珠样”改变,静脉旁多发散在视网膜前出血,对应静脉处可见白色栓子样梗塞,动脉变细,反光增强(图1A)。红外眼底扫描激光检查,右眼仅见上方及颞侧涡静脉轮廓(图1B)。光相干断层扫描(OCT)检查,右眼黄斑区鼻侧视网膜水肿增厚,视网膜层间结构模糊,脉络膜厚度不均(图1C)。左眼眼前节及眼底检查均未见明显异常。展开更多
Background: Retinal vessels may provide information on cerebral vascular pathology, because they share many features with cerebral vessels. A smaller ratio of the retinal arteriolar-to-venular diameters reportedly pre...Background: Retinal vessels may provide information on cerebral vascular pathology, because they share many features with cerebral vessels. A smaller ratio of the retinal arteriolar-to-venular diameters reportedly predicts the risk of stroke. It is unclear if this is due to arteriolar narrowing or venular dilation. Objective: To investigate whether smaller arteriolar or larger venular diameters are related to the risk of stroke and cerebral infarction. Methods: This study was based on the prospective population-based Rotterdam Study and included 5,540 participants of 55 years or over, who had gradable fundus transparencies and were free of stroke at baseline (1990 to 1993). For each participant, retinal arteriolar and venular diameters were measured on digitized images of one eye. Follow-up for first-ever stroke was complete until January 1, 2002. Results: After a mean follow-up of 8.5 years, 411 participants had a stroke, of whom 259 had cerebral infarction. Larger venular diameters were associated with an increased risk of stroke (hazard ratio [HR] adjusted for age and sex per SD increase: 1.12 [95%CI: 1.02 to 1.24]) and cerebral infarction (HR: 1.15 [95%CI: 1.02 to 1.29]). Smaller arteriolar diameters were neither related to the risk of stroke (HR per SD decrease: 1.02 [95%CI: 0.93 to 1.13]) nor to the risk of cerebral infarction (HR: 1.02 [95%CI: 0.90 to 1.15]). After additional adjustment for other cardiovascular risk factors, the results did not change. Conclusions: Larger retinal venular diameters are associated with an increased risk of stroke and cerebral infarction. The role of venules in cerebrovascular disease warrants further exploration.展开更多
Purpose:To measure the oxygen saturation(SO2)in retinal arterioles and venules in patients with glaucomatous optic neuropathy.Methods:We examined SO2 in retinal arterioles and venules simultaneously by imaging spectro...Purpose:To measure the oxygen saturation(SO2)in retinal arterioles and venules in patients with glaucomatous optic neuropathy.Methods:We examined SO2 in retinal arterioles and venules simultaneously by imaging spectrometry.Oxygen saturationwas evaluated according to the difference of the extinction spectra of haemoglobin and oxyhaemog-lobin.The arterio-venous difference(avD)was calculated by(SO2art-SO2ven).The optic nerve head topography was estimated by Heidelberg retinal tomography and the visual field using the Octopus G1.We examined one eye in each of 58 healthy persons(mean age 58.6 ± 10.7 years;mean rim area 1.52± 0.33mm2;mean defect 0.65± 1.31 dB;mean intraocular pressure IOP 18.5± 2.7 mmHg),49 patients with normal-tension primary open-angle glaucoma(NTG)(mean age 63.0± 8.5 years;mean rim area 0.89± 0.34 mm2;mean defect 5.4± 4.1dB;mean IOP 19.2± 2.9 mmHg),and 45 patients with high-tension primary open-angle glaucoma(POAG)(mean age 62.6± 10.3 years;mean rim area 0.97± 0.47 mm2;mean defect 7.1± 6.4 dB;mean IOP 31.6± 10.8 mmHg).Results:The intraclass correlation coefficients of the SO2 measurement were 0.82(arteriole)and 0.59(venule).In normal eyes,the SO2art,SO2ven and avD were 92.3± 3.4%,55.7 ± 6.8% and 36.6± 7.0%,respectively.Equivalent data were 89.7± 5.4%,56.0± 8.3% and 33.7± 10.6%,respectively,in NTG eyes and 91.4± 4.0%,58.3± 10.5% and 33.1± 11.5%,respectively,in POAG eyes.Over all examined eyes,the arteriolar SO2 and the retinal arterio-venous difference correlated significantly with the rim area.Conclusion:Eyes with NTG showed significantly decreased arteriolar SO2.These changes were not seen in POAG patients.展开更多
文摘患者女,26岁。因突发右眼视物不清1 d,于2023年4月13日到遵义医科大学第二附属医院眼科就诊。患者半个月前因右侧腘静脉血栓栓塞行下腔静脉滤器置入手术及尿激酶溶栓、那屈肝素钠抗凝治疗。否认其他全身病史。眼科检查:右眼、左眼最佳矫正视力分别为数指/10 cm、1.0。右眼、左眼眼压分别为14、11 mm Hg(1 mm Hg=0.133 kPa)。右眼直接对光反射消失。眼底检查,右眼视盘水肿,盘缘小片状出血,视网膜静脉纡曲扩张,“串珠样”改变,静脉旁多发散在视网膜前出血,对应静脉处可见白色栓子样梗塞,动脉变细,反光增强(图1A)。红外眼底扫描激光检查,右眼仅见上方及颞侧涡静脉轮廓(图1B)。光相干断层扫描(OCT)检查,右眼黄斑区鼻侧视网膜水肿增厚,视网膜层间结构模糊,脉络膜厚度不均(图1C)。左眼眼前节及眼底检查均未见明显异常。
文摘Background: Retinal vessels may provide information on cerebral vascular pathology, because they share many features with cerebral vessels. A smaller ratio of the retinal arteriolar-to-venular diameters reportedly predicts the risk of stroke. It is unclear if this is due to arteriolar narrowing or venular dilation. Objective: To investigate whether smaller arteriolar or larger venular diameters are related to the risk of stroke and cerebral infarction. Methods: This study was based on the prospective population-based Rotterdam Study and included 5,540 participants of 55 years or over, who had gradable fundus transparencies and were free of stroke at baseline (1990 to 1993). For each participant, retinal arteriolar and venular diameters were measured on digitized images of one eye. Follow-up for first-ever stroke was complete until January 1, 2002. Results: After a mean follow-up of 8.5 years, 411 participants had a stroke, of whom 259 had cerebral infarction. Larger venular diameters were associated with an increased risk of stroke (hazard ratio [HR] adjusted for age and sex per SD increase: 1.12 [95%CI: 1.02 to 1.24]) and cerebral infarction (HR: 1.15 [95%CI: 1.02 to 1.29]). Smaller arteriolar diameters were neither related to the risk of stroke (HR per SD decrease: 1.02 [95%CI: 0.93 to 1.13]) nor to the risk of cerebral infarction (HR: 1.02 [95%CI: 0.90 to 1.15]). After additional adjustment for other cardiovascular risk factors, the results did not change. Conclusions: Larger retinal venular diameters are associated with an increased risk of stroke and cerebral infarction. The role of venules in cerebrovascular disease warrants further exploration.
文摘Purpose:To measure the oxygen saturation(SO2)in retinal arterioles and venules in patients with glaucomatous optic neuropathy.Methods:We examined SO2 in retinal arterioles and venules simultaneously by imaging spectrometry.Oxygen saturationwas evaluated according to the difference of the extinction spectra of haemoglobin and oxyhaemog-lobin.The arterio-venous difference(avD)was calculated by(SO2art-SO2ven).The optic nerve head topography was estimated by Heidelberg retinal tomography and the visual field using the Octopus G1.We examined one eye in each of 58 healthy persons(mean age 58.6 ± 10.7 years;mean rim area 1.52± 0.33mm2;mean defect 0.65± 1.31 dB;mean intraocular pressure IOP 18.5± 2.7 mmHg),49 patients with normal-tension primary open-angle glaucoma(NTG)(mean age 63.0± 8.5 years;mean rim area 0.89± 0.34 mm2;mean defect 5.4± 4.1dB;mean IOP 19.2± 2.9 mmHg),and 45 patients with high-tension primary open-angle glaucoma(POAG)(mean age 62.6± 10.3 years;mean rim area 0.97± 0.47 mm2;mean defect 7.1± 6.4 dB;mean IOP 31.6± 10.8 mmHg).Results:The intraclass correlation coefficients of the SO2 measurement were 0.82(arteriole)and 0.59(venule).In normal eyes,the SO2art,SO2ven and avD were 92.3± 3.4%,55.7 ± 6.8% and 36.6± 7.0%,respectively.Equivalent data were 89.7± 5.4%,56.0± 8.3% and 33.7± 10.6%,respectively,in NTG eyes and 91.4± 4.0%,58.3± 10.5% and 33.1± 11.5%,respectively,in POAG eyes.Over all examined eyes,the arteriolar SO2 and the retinal arterio-venous difference correlated significantly with the rim area.Conclusion:Eyes with NTG showed significantly decreased arteriolar SO2.These changes were not seen in POAG patients.
