| 摘要: |
| ［摘要］ 目的 探讨眼眶血流超声（OCDI）诊断视网膜中央动脉阻塞的临床应用价值。方法 选择2015年1月至2021年9月中国人民解放军陆军军医大学第二附属医院收治的34例（34眼）视网膜中央动脉阻塞患者的临床资料，其中年龄<60岁者15例（15眼），≥60岁者19例（19眼）。另纳入同期健康者30名（30眼）作为对照组。通过OCDI检测患者的患侧眼和健侧眼视网膜中央动脉血流动力学指标，包括收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、阻力指数（RI）及搏动指数（PI）。通过Kappa一致性检验分析荧光素眼底血管造影术(FFA)检查结果与OCDI检查结果的一致性。分析OCDI检查为阴性的视网膜中央动脉阻塞患者的临床特征。结果 视网膜中央动脉阻塞患者患侧眼PSV、EDV水平低于健侧眼，RI、PI水平高于健侧眼，差异有统计学意义（P<0.05）。年龄≥60岁的视网膜中央动脉阻塞患者患侧眼PI水平显著高于对照组（P<0.05），但与健侧眼比较差异无统计学意义（P>0.05），PSV、EDV及RI指标在患侧眼、健侧眼和对照组间比较差异无统计学意义（P>0.05）。年龄<60岁的视网膜中央动脉阻塞患者患侧眼PSV、EDV水平显著低于健侧眼和对照组（P<0.05），PI、RI水平显著高于对照组（P<0.05），但与健侧眼比较差异无统计学意义（P>0.05）。OCDI与FFA诊断视网膜中央动脉阻塞结果具有较好的一致性（Kappa=0.807，P<0.001）。OCDI诊断阴性者发病至就诊时间迟于阳性者，差异有统计学意义（P<0.05），其患侧眼与健侧眼PSV、EDV及RI比较差异无统计学意义（P>0.05）。结论 视网膜中央动脉阻塞患者的视网膜中央动脉的血流动力学均发生显著改变，OCDI检查有助于视网膜中央动脉阻塞的早期诊断。 |
| 关键词: 视网膜中央动脉阻塞 眼眶血流超声 荧光素眼底血管造影术 血流动力学 |
| DOI：10.3969/j.issn.1674-3806.2023.12.12 |
| 分类号:R 770.4 |
| 基金项目: |
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| An investigation on clinical application of orbital color Doppler imaging in diagnosis of central retinal artery occlusion |
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HUANG Chan-juan, LI Pei-jing, YAUN Rong-di
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Department of Ophthalmology, the Second Affiliated Hospital of Army Medical University, Chongqing 400038, China
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| Abstract: |
| ［Abstract］ Objective To investigate the clinical application value of orbital color Doppler imaging(OCDI) in diagnosis of central retinal artery occlusion. Methods The clinical data of 34 patients(34 eyes) with central retinal artery occlusion who were admitted to the Second Affiliated Hospital of Army Medical University from January 2015 to September 2021 were selected, including 15 patients(15 eyes) aged <60 years and 19 patients(19 eyes) aged ≥60 years. Other 30 healthy subjects(30 eyes) during the same period were included as the control group. The hemodynamics indicators of the central retinal artery in the affected eyes and the healthy eyes of the patients were detected using OCDI, including peak systolic velocity(PSV), end diastolic velocity(EDV), resistance index(RI) and pulsatility index(PI). Kappa consistency test was used to analyze the consistency between the findings of fluorescein fundus angiography(FFA) and the findings of OCDI. The clinical features of the patients with central retinal artery occlusion whose OCDI was negative were analyzed. Results The PSV and EDV levels in the affected eyes of the patients with central retinal artery occlusion were lower than those in the healthy eyes, and the RI and PI levels in the affected eyes were higher than those in the healthy eyes, and the differences were statistically significant(P<0.05). The PI level in the affected eyes of the central retinal artery occlusion patients aged ≥60 years was significantly higher than that in the affected eyes of the patients in the control group(P<0.05), but there was no significant difference in the PI level between the affected eyes and the healthy eyes of the central retinal artery occlusion patients(P>0.05). There were no significant differences in the indicators of PSV, EDV and RI among the affected eyes, the healthy eyes and the control group(P>0.05). For the central retinal artery occlusion patients aged <60 years, the levels of PSV and EDV in the affected eyes were significantly lower than those in the healthy eyes and the control group(P<0.05), and the levels of PI and RI were higher than those in the control group(P<0.05), but there was no statistically significant difference between the patients and the healthy eyes(P>0.05). OCDI and FFA had good consistency in the diagnosis of central retinal artery occlusion(Kappa=0.807, P<0.001). The time from onset to visiting the doctor in the patients with negative OCDI diagnosis was later than that of the patients with positive OCDI diagnosis(P<0.05), and the difference was statistically significant(P<0.05). There were no significant differences in PSV, EDV and RI between the affected eyes and the healthy eyes of the patients with negative OCDI diagnosis(P>0.05). Conclusion The hemodynamics of central retinal artery in patients with central retinal artery occlusion are significantly changed. OCDI examination is helpful for early diagnosis of central retinal artery occlusion. |
| Key words: Central retinal artery occlusion Orbital color Doppler imaging(OCDI) Fluorescein fundus angiography(FFA) Hemodynamics |
