中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
3期
243-247
,共5页
脉络膜视网膜炎%荧光素血管造影术%吲哚花青绿%血管造影术%血流动力学
脈絡膜視網膜炎%熒光素血管造影術%吲哚花青綠%血管造影術%血流動力學
맥락막시망막염%형광소혈관조영술%신타화청록%혈관조영술%혈류동역학
Chorioretinitis%Fluorescein angiography%Indocyanine green%Angiography%Hemodynamics
目的 探讨中心性浆液性脉络膜视网膜病变(CSC)患者眼球后血管血流动力学变化特征、脉络膜循环异常特点及其与视网膜色素上皮病变的关系.方法 病例对照研究.应用彩色超声多普勒检测57例(57只患眼,57只对侧眼)CSC单侧受累患者及25例(50只眼)正常对照者的眼动脉、睫状后动脉、睫状后短动脉,记录其血管收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)及阻力指数(RI),并对CSC患者的患眼、对侧眼及正常对照眼的血流参数两两间分别进行比较研究.采用海德堡激光扫描眼底造影系统,对57例患者行同步吲哚氰绿脉络膜血管造影(ICGA)、荧光素眼底血管造影(FFA),并对其图像进行对比分析.采用SPSS 12.0统计学软件.对CSC患者的患眼与对侧眼的眼动脉、颞侧睫状后动脉、颢侧睫状后短动脉的PSV、EDV、RI血流参数进行比较,采用自身配对t检验;对正常对照眼与CSC患者的对侧眼和患眼血流参数进行比较,采用成组设计t枪验.以P＜0.05作为差异有统计学意义.结果 CSC患者的患眼和正常对照者的颞侧睫状后动脉(PSV:t=3.044,P=0.005;EDV:t=3.731,P=0.001)、颞侧睫状后短动脉(PSV:t=2.822,P=0.008;EDV:t=3.194,P=0.003),患者对侧眼和正常对照者的颞侧睫状后动脉(PSV:t=3.219,P=0.003;EDV:t=3.807,P=0.001)、颞侧睫状后短动脉(PSV:t=3.931,P=0.000,EDV:t=3.145,P=0.003)血流参数均下降,差异有统计学意义(P＜0.05).患者的患眼与对侧眼的颞侧睫状后动脉(PSV:t=0.608,P=0.548;EDV:t=0.122,P=0.904)、颞侧睫状后短动脉(PSV:t=0.730,P=0.470;EDV:t=0.109,P=0.914)的血流参数比较,差异均无统计学意义(P＞0.05).ICGA、FFA检查结果显示,57例患者的患眼所有视网膜色素上皮渗漏点均出现在相对应的脉络膜弱荧光区内,其中52例在早期弱荧光区内继发脉络膜血管扩张,晚期呈现高荧光渗漏灶.患眼和对侧眼所有视网膜色素上皮窗样荧光处,相对应的脉络膜部位,在ICGA造影晚期均呈现高荧光渗漏灶.而20只患眼及其16只对侧眼的脉络膜在ICGA晚期呈现高荧光渗漏灶处,经FFA检查未见视网膜色素上皮窗样荧光.结论 CSC是与全身因素有关的舣眼疾病,其眼球后和脉络膜微循环异常的基本特征为血管的低灌注和缺血,视网膜色素上皮病变继发于脉络膜微循环异常.(中华眼科杂志,2009,45:243-247)
目的 探討中心性漿液性脈絡膜視網膜病變(CSC)患者眼毬後血管血流動力學變化特徵、脈絡膜循環異常特點及其與視網膜色素上皮病變的關繫.方法 病例對照研究.應用綵色超聲多普勒檢測57例(57隻患眼,57隻對側眼)CSC單側受纍患者及25例(50隻眼)正常對照者的眼動脈、睫狀後動脈、睫狀後短動脈,記錄其血管收縮期峰值血流速度(PSV)和舒張末期血流速度(EDV)及阻力指數(RI),併對CSC患者的患眼、對側眼及正常對照眼的血流參數兩兩間分彆進行比較研究.採用海德堡激光掃描眼底造影繫統,對57例患者行同步吲哚氰綠脈絡膜血管造影(ICGA)、熒光素眼底血管造影(FFA),併對其圖像進行對比分析.採用SPSS 12.0統計學軟件.對CSC患者的患眼與對側眼的眼動脈、顳側睫狀後動脈、顥側睫狀後短動脈的PSV、EDV、RI血流參數進行比較,採用自身配對t檢驗;對正常對照眼與CSC患者的對側眼和患眼血流參數進行比較,採用成組設計t鎗驗.以P＜0.05作為差異有統計學意義.結果 CSC患者的患眼和正常對照者的顳側睫狀後動脈(PSV:t=3.044,P=0.005;EDV:t=3.731,P=0.001)、顳側睫狀後短動脈(PSV:t=2.822,P=0.008;EDV:t=3.194,P=0.003),患者對側眼和正常對照者的顳側睫狀後動脈(PSV:t=3.219,P=0.003;EDV:t=3.807,P=0.001)、顳側睫狀後短動脈(PSV:t=3.931,P=0.000,EDV:t=3.145,P=0.003)血流參數均下降,差異有統計學意義(P＜0.05).患者的患眼與對側眼的顳側睫狀後動脈(PSV:t=0.608,P=0.548;EDV:t=0.122,P=0.904)、顳側睫狀後短動脈(PSV:t=0.730,P=0.470;EDV:t=0.109,P=0.914)的血流參數比較,差異均無統計學意義(P＞0.05).ICGA、FFA檢查結果顯示,57例患者的患眼所有視網膜色素上皮滲漏點均齣現在相對應的脈絡膜弱熒光區內,其中52例在早期弱熒光區內繼髮脈絡膜血管擴張,晚期呈現高熒光滲漏竈.患眼和對側眼所有視網膜色素上皮窗樣熒光處,相對應的脈絡膜部位,在ICGA造影晚期均呈現高熒光滲漏竈.而20隻患眼及其16隻對側眼的脈絡膜在ICGA晚期呈現高熒光滲漏竈處,經FFA檢查未見視網膜色素上皮窗樣熒光.結論 CSC是與全身因素有關的艤眼疾病,其眼毬後和脈絡膜微循環異常的基本特徵為血管的低灌註和缺血,視網膜色素上皮病變繼髮于脈絡膜微循環異常.(中華眼科雜誌,2009,45:243-247)
목적 탐토중심성장액성맥락막시망막병변(CSC)환자안구후혈관혈류동역학변화특정、맥락막순배이상특점급기여시망막색소상피병변적관계.방법 병례대조연구.응용채색초성다보륵검측57례(57지환안,57지대측안)CSC단측수루환자급25례(50지안)정상대조자적안동맥、첩상후동맥、첩상후단동맥,기록기혈관수축기봉치혈류속도(PSV)화서장말기혈류속도(EDV)급조력지수(RI),병대CSC환자적환안、대측안급정상대조안적혈류삼수량량간분별진행비교연구.채용해덕보격광소묘안저조영계통,대57례환자행동보신타청록맥락막혈관조영(ICGA)、형광소안저혈관조영(FFA),병대기도상진행대비분석.채용SPSS 12.0통계학연건.대CSC환자적환안여대측안적안동맥、섭측첩상후동맥、호측첩상후단동맥적PSV、EDV、RI혈류삼수진행비교,채용자신배대t검험;대정상대조안여CSC환자적대측안화환안혈류삼수진행비교,채용성조설계t창험.이P＜0.05작위차이유통계학의의.결과 CSC환자적환안화정상대조자적섭측첩상후동맥(PSV:t=3.044,P=0.005;EDV:t=3.731,P=0.001)、섭측첩상후단동맥(PSV:t=2.822,P=0.008;EDV:t=3.194,P=0.003),환자대측안화정상대조자적섭측첩상후동맥(PSV:t=3.219,P=0.003;EDV:t=3.807,P=0.001)、섭측첩상후단동맥(PSV:t=3.931,P=0.000,EDV:t=3.145,P=0.003)혈류삼수균하강,차이유통계학의의(P＜0.05).환자적환안여대측안적섭측첩상후동맥(PSV:t=0.608,P=0.548;EDV:t=0.122,P=0.904)、섭측첩상후단동맥(PSV:t=0.730,P=0.470;EDV:t=0.109,P=0.914)적혈류삼수비교,차이균무통계학의의(P＞0.05).ICGA、FFA검사결과현시,57례환자적환안소유시망막색소상피삼루점균출현재상대응적맥락막약형광구내,기중52례재조기약형광구내계발맥락막혈관확장,만기정현고형광삼루조.환안화대측안소유시망막색소상피창양형광처,상대응적맥락막부위,재ICGA조영만기균정현고형광삼루조.이20지환안급기16지대측안적맥락막재ICGA만기정현고형광삼루조처,경FFA검사미견시망막색소상피창양형광.결론 CSC시여전신인소유관적의안질병,기안구후화맥락막미순배이상적기본특정위혈관적저관주화결혈,시망막색소상피병변계발우맥락막미순배이상.(중화안과잡지,2009,45:243-247)
objectivc To analyze the characteristics of the retrobulbar blood vessels'hemodynamics changes and the choroidal circulation disorder,and to observe the relations between retinal pigment epithelium's(RPE)pathological changes and them.Methods It was a case control study.For 57(57 affected eyes and 57 contralateral eyes)unilateral eye affected patients and 25(50 eyes)normal health adults,we examined ophthalmic arteries(OA),posterior ciliary arteries(PCA)and short posterior ciliary arteryies(SPCA)by color Doppler flow Imaging(CDFI),and recorded the peak systolic velocities(PSV),end diastolic velocities(EDV)and resistance indexes(RI)of them.We compared each hemodynamic parameter of the normal eyes with it of the affected eyes and contralateral eyes in patients group respectively,and contrasted them between affected eyes and contralateral eyes of the patients.Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were performed simultaneously on 57 patients with Heidelberg retina angiography,and the images were analyzed in contrast.We used SPSS 12.0 statistics software was used in the study.To the PSV,EDV and RI of the OA,PCA and SPCA in affected eyes and contralateral eyes of the patients,we used paired t-test for the same sample to compare their hemodynamic parameters:to compare normal health adults'eyes with the affected eyes and the contralateral eyes of patients group respectively,we used two-group t-test.When the P-value was less than 0.05,there was a statistical significanoe.Results There wag a more significant decrease of the hemodynamic parameters in beth PSVs and EDVs of temporal PCAs(PSV:t=3.044,P=0.005;EDV:t=3.731,P=0.001)and temporal SPCA8(PsV:t=2.822,P=0.008;EDV:t=3.194,P=0.003)compared the patients group's affected eyes with normal health adults group eyes,there was a more significant decrease of them of temporal PCAs(PSV:t=3.219,P=0.003;EDV:t=3.807,P=0.001)and temporal SPCAs(PSV:t=3.931,P=0.000,EDV:t=3.145,P=0.003)compared the patients group's contralateral eyes with normal health adults group eyes,and there was a statistical significance of them(P＜0.05).There was no difierence in hemodynamic parameters of both PsVs and EDVs of temporal PCAs(PSV:t=0.608,P=0.548;EDV:t=0.122,P=0.904)and temporal SPCAs(PSV:t=0.730,P=0.470;EDV:t=0.109,P=0.914)between affected eyes and contralateral eyes of the patients,and there was no statistical significance of them(P＞0.05).The results of FFA and ICGA showed that all the RPE's leaks of 57 affected eyes appeared at the hypofluoresceint regions of relative choroids;52 cases of 57 affected eyes were followed by choroidal vessels dilatation at the early hypofluoresceint regions,and appeared hyperfluorescence leakages in the late phase images:At the all regions of RPE's transmitted fluorescences of affected eyes and contralateral eyes,the corresponding choroids showed hyperfluorescence in the late phase images in ICGA;There were no RPE's transmitted fluorescences at the regions of 20 affected eyes and 16 contralateral eyes in FFA,which showed hyperfluoresceince leakages in the late phabe images of choroids in ICGA.Conclusions CSC is possibly a bilateral disease associated with systemic pathologic conditions.Hypoperfusion and ischemia are the basal characteristics of retrobulbar blood vessels'circulation disorder and choroidal ultracirculation disorder.The damage of RPE is following to the choroidal circulation disorder.(Clan J Ophthalmol,2009,45:243-247)
