放射性视神经视网膜病变眼血流动力学的研究

目的：探讨放射性视神经视网膜病变患者眼血流动力学的变化及血管因素对其视功能损害的影响。方法：应用彩色多谱勒血流成像技术（color doppler flowi maging,CDFI）检测放射性视网膜病变（Radiative Retinopathy,RR）36例70只眼;放射性视神经病变（Radiative Optic Neuropathy,RON）13例25只眼的视网膜中央动脉（central retinal artery,CRA）、鼻、颞侧睫状后短动脉（short posterior ciliary artery,SPCA）、眼动脉（ophthal mic artery,OA）的收缩期峰值血流速度（peak systolic velocity,PSV）、舒张末期血流速度（end-diastolic velocity,EDV）及阻力指数（resistance index,RI）,并与26例（52只眼）正常对照组相应的血流动力学参数进行比较。结果：与对照组比较放射性视网膜病变组和放射性视神经病变组CRA和SPCA的PSV、EDV明显降低（P〈0.01和P〈0.05）;CRA、SPCA的RI明显升高（P〈0.05）,OA除EDV明显降低（P〈0.01）外,PSV及RI比较差异无统计学意义（P〉0.05）。结论：放射性视神经视网膜病变存在视网膜CRA、SPCA的血流动力学异常。放射性视神经视网膜病变的发生发展与视网膜CRA、SPCA的供血不足密切相关。

A STUDY ON THE HEMODYNAMICS OF RADIATION-INDUCED OPTIC NEUROPATHY & RETINOPATHY

Objective：To observe the changes of eye hemodynamics in patients with radiation-induced optic neuropathy（RON） retinopathy（RR）in order to approach the role of blood vessels impairment in it.Methods：Thirty-six patients with RON in 70 eyes,13 patients with RR in 25 eyes and 26 people with 52 normal eyes（as control）were included in this study.We used Color Doppler flow imaging（CDFI）to measure the peak systolic velocity（PSV）,end-diastolic velocity（EDV）and resistance index（RI）of the central retinal artery（CRA）,nasal temple short posterior ciliary artery（SPCA）and ophthalmic artery（OA）in the all eyes.All these parameters were compared between the patients and the controls.Results：Compared with the control,for the patients with RON RR,the PSV and EDV of the CRA,the SPCA of PSV and EDV were significantly decreased（P〈0.01 and P〈0.05,respectively）while the RI of CRA and SPCA were significantly increased（P〈0.05）.For the OA,the EDV was significantly decreased（P〈0.01）while the PSV and RI had no difference statistically.Conclusion：CDFI is a credible technology for providing the changes of the blood flow dynamics in the eyes with RON and RR.Our study indicates the existence of the dynamics abnormality of CRA and SPCA in the eyes with RON and RR.The deficient blood supply of the CRA and SPCA may play an important role in the development of the RON and RR.