非动脉炎性视网膜中央动脉阻塞伴同侧颈内动脉闭塞患者的眼底影像特征

目的 探讨非动脉炎性视网膜中央动脉阻塞(NA-CRAO)伴同侧颈动脉闭塞患者的眼底影像特征。方法 回顾性研究。选择2019年11月至2021年11月在西安市人民医院(西安市第四医院)眼科住院治疗的NA-CRAO伴同侧颈内动脉闭塞患者32例32眼为颈内动脉闭塞组，选择同期住院治疗的NA-CRAO不伴有颈内动脉闭塞患者32例32眼为对照组。采用国际标准视力表检测患者最佳矫正视力(BCVA);对患者行瞳孔、眼球运动、裂隙灯显微镜、眼底彩色照相、OCT、荧光素眼底血管造影(FFA)、颈部血管超声多普勒、颅脑磁共振(MRI)、磁共振血管成像(MRA)检查。比较两组患者的臂-视网膜循环时间(A-Rct)、主干-末梢荧光素充盈时间(FT)、FFA特征、BCVA、眼底彩色照相、虹膜新生血管以及黄斑OCT特征。结果 颈内动脉闭塞组和对照组患者年龄、性别、眼别、发病时间以及高血压、糖尿病、高脂血症、高同型半胱氨酸血症患病率差异均无统计学意义(均为P>0.05);颈内动脉闭塞组患者A-Rct和FT较对照组均显著延长，差异均有统计学意义(P=0.016、0.003);颈内动脉闭塞组与对照组患者BCVA差...

Fundus imaging features of non-arteritic central retinal artery occlusion patients with ipsilateral internal carotid artery occlusion

Objective　To investigate the fundus imaging features of patients with non-arteritic central retinal artery occlusion (NA-CRAO) accompanied by ipsilateral internal carotid artery occlusion (ICAO). Methods　A retrospective study was conducted. A total of 32 NA-CRAO patients (32 eyes) with ipsilateral ICAO hospitalized in Xi’an People’s Hospital (Xi’an Fourth Hospital) from November 2019 to November 2021 were included in the ICAO group, and a total of 32 NA-CRAO patients (32 eyes) without ICAO were selected as the control group. The best corrected visual acuity (BCVA) was determined by the international standard visual acuity chart, pupillary and eye movement examinations were conducted, slit-lamp microscopic examination was carried out, and fundus color photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA), cervical vascular doppler ultrasound, cerebral magnetic resonance imaging as well as magnetic resonance angiography were performed. The arm-retinal circulation time (A-Rct), trunk-terminal fluorescein filling time (FT), FFA features, BCVA, fundus color photography, iris neovascularization and OCT features of the macula in the two groups were compared. Results　There was no significant difference in age, onset time, gender, eye side and prevalence rates of hypertension, diabetes, hyperlipidemia and hyperhomocysteinemia between the two groups (all P>0.05). Both A-Rct and FT in the ICAO group were significantly longer than those in the control group (P=0.016, 0.003). The BCVA in the ICAO group had a significant difference from that in the control group (P=0.014). The incidence rates of weakened choroidal background fluorescence, phlebectasia with fluorescein leakage, iris neovascularization, perimacular retinal capillary hemorrhage, retinal artery fluorescein filling retrograde,non-perfusion area of macula, perimacular small artery fluorescein leakage and acute cerebral infarction in the ICAO group were higher than those in the control group, with statistical significances (all P<0.05). The thicknesses of central macular retina and perimacular retina of patients in the ICAO group were higher than those in the control group, with significant differences (P=0.000, 0.003). The incidence rate of cystoid macular edema in the ICAO group was significantly higher than that in the control group (P=0.000). Conclusion　If NA-CRAO patients have a severe visual impairment, a wide range of retinal ischemia, significantly prolonged A-Rct and FT, retrograde filling, non-perfusion zone in the macula, fluorescein leakage from perimacular arterioles, retinal vein dilatation with fluorescein leakage but no tortuosity, iris neovascularization or cystoid macular edema, the presence of ipsilateral ICAO should be considered, and the neurovascular imaging evaluation should be performed as soon as possible.