摘要
目的探讨与颈动脉狭窄相关眼部表现的临床特点和发生机制。方法回顾性分析124例颈动脉狭窄患者的临床资料和相关眼部表现的情况。结果36例(29%)患者伴有眼部表现,并且28例(22.6%)是以眼部的症状为首发症状就诊;36例患者中,31例(86.1%)经彩色超声多普勒(CDFI)检查显示狭窄段主要位于单侧或双侧颈内动脉,数字减影血管造影(DSA)检查显示为颈内动脉中度狭窄8例,重度狭窄23例;124例患者中,67例重度颈内动脉狭窄患者出现眼部表现的概率与34例中度狭窄患者比较,差异无统计学意义(χ2检验,P=0.2662,P>0.05);眼部表现包括一过性黑目蒙52.8%,视野缺损、视力突然下降甚至完全丧失36.1%,双眼复视13.9%,上睑下垂13.9%,持续性高眼压2.8%,同一患者可同时合并多种表现;36例患者中诊断视网膜中央动脉阻塞4例,视网膜静脉瘀滞性病变1例,视网膜中央静脉或分支静脉阻塞6例,新生血管性青光眼1例,前部缺血性视神经病变2例;1例患者双侧颈内动脉完全闭塞并无任何眼部表现。结论颈动脉尤其是颈内动脉狭窄可引起急慢性缺血性眼病,但慢性缺血情况下是否有眼部的表现与侧支循环代偿状态有关;对缺血性眼病患者建议常规检查颈动脉系统情况。
Objective To investigate manifestations related to carotid artery stenosis. the clinical characteristics and mechanisms of ocular Methods The general clinic data and related ocular manifestations in 124 patients with carotid artery stenosis were retrospectively. Results In the 124 patients, 36 （29%） had ocular manifestations, and 28 （22, 6%） complained the ocular discomfort as the first symptom. Among the 36 patients, 31 patients （86. 1%） had been disclosed unilateral or double stenosis of internal carotid artery by carotid Doppler ultrasound examination, and the result of digital subtract angiography revealed middle and severe degree of internal carotid artery stenosis in 8 and 23 patients respectively. There was no statistic difference of incidence of ocular manifestations between 67 patients of severe internal carotid artery stenosis and 34 patients with middle one （X^2 test,P=0. 266 2,P〉0.05）. The ocular manifestations included amaurosis fugax （52.8%）, acute decline or loss of the visual ability and defect of visual fields （36.1%）, binocular diplopia （13.9%）, ptosis （13.9%）, and persistent high intraocular pressure （2.8%）; one patient might had several ocular manifestations simultaneously. In 36 patients, central retinal artery occlusion had been diagnosed in 4, venous stasis retinopathy in 1 ,central or branch retinal vein occlusion in 6, neovascular glaucoma in 1, and anterior ischemic optic neuropathy in 2. One patient with double occlusion of internal carotid artery didn＇t have any ocular manifestation. Conclusion Carotid artery stenosis, especially internal carotid artery may lead to acute or chronic ocular ischemic lesions, and the occurrence of ocular manifestations in chronic ocular ischemic lesions relates to compensation of collateral circulation;patients with ocular ischemic lesions are recommend to undergo a routine carotid artery examination.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2006年第6期376-378,共3页
Chinese Journal of Ocular Fundus Diseases
