青光眼视神经损害与眼局部及全身血流动力学关系的研究

目的 探讨青光眼视神经损害与眼局部及全身血流动力学之间的关系。方法 对３４例原发开角型青光眼,３１例低压性青光眼及９０名正常人进行彩色超声多普勒图象研究,测量双眼眼动脉,视网膜中央动脉,睫状后动脉的收缩期峰值血流速度和舒张末期血流速度,通过公式计算阻力指数,并行甲襞微循环及血液粘度检查。

The relationship between ophthalmic nerve lesion in glaucoma and ocular and systemic haemodynamic disturbance

Objective To explore the relationship between the optic nerve lesion in glaucoma and ocular and systemic heamodynamic disturbance. Methods The color Doppler imaging was used to study blood velocity in the ophthalmic, the central retinal and the short posterior ciliary arteries in 34 patients with primary open angle glaucoma , 31 patients with low tention glaucoma and 90 healthy controls. The peak systolic velocity(PSV), the end diastolic velocity (EDV) and resistive index (RI) in each artery were measured, moreover the nailfold microcirculation and blood viscosity in each patient were examined. Results Compared with the control group, the PSV and EDV of the central retinal arteries were significantly lower while the RI of the central retinal arteries was significantly higher in both POAG and LTG patients. The RI of the short posterior ciliary arteries however was significantly higher in POAG. Nailfold microcirculation shows that some important parameters, including flow pattern, loop surrounding, morphological weighted value, total weighted value and capillary deformity rate in the two glaucoma groups were higher, whereas the flow velocity was lower than in the control group. The plasm viscosity and the whole blood viscosity (low spear) were higher than normal. According to our measurements, the nailfold microcirculation and blood viscosity was worse at the end stage of glaucoma than at early stage. The correlative analysis between measurement results of color doppler imaging and microcirculation and heamorrheology showed that nailfold microcirculation morphological weighted value was negatively correlated with the EDV of the central retinal artery and positively correlated with the RI of the central retinal artery in LTG patients. Conclusions The abnormity of ocular haemodynamics and systemic microcirculation and blood viscosity is one important factor of optic nerve damage in glaucoma.