Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (4): 64-68.doi: 10.6040/j.issn.1673-3770.1.2020.052

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Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue1, WANG Haiwei2, LI Wensi1, YANG Xintong1, SUN Cun1, ZHAO Yuan1, ZHAO Pengbo1, ZHANG Jianqiang1 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract:

ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.   

  1. Key words:Spectral domain;
    Optical coherence tomography;
    Hypertension;
    Classification;
    Retina;
    vascular diameter全球高血压的患病率呈升高趋势, 预计2025年将累及全世界近1/3的人口[1]。高血压可引起眼[2]、脑[3]、肾[4]等多个靶器官损害。高血压早期, 视网膜动脉痉挛变细[5], 随着高血压的进展, 可出现高血压性小动脉硬化改变, 即视网膜动脉管腔狭窄等病理变化[6]。关于高血压的不同类型对视网膜血管管径影响的相关研究报道较少。我们应用频域光学相干断层成像(Spectral domain optical coherence tomography, SD-OCT)对以下三种类型的高血压即单纯收缩期高血压(isolated systolic hypertension, ISH)、单纯舒张期高血压(isolated diastolic hypertension, IDH)、收缩期和舒张期联合性高血压(systolic combined with diastolic hypertension, SDH)患者的视网膜血管管径进行测量, 旨在探讨视网膜血管管径在不同高血压类型方面的差异。
  • Received:2020-05-22 Online:2020-07-20 Published:2020-08-28

Abstract: Objective To analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). Methods This was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. Results There were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). Conclusions Among the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.

Key words: Spectral domain, Optical coherence tomography, Hypertension, Classification, Retina, vascular diameter

CLC Number: 

  • R774.1
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[1] Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.. Application progress of thrombolysis in retinal artery occlusionYANG Ming Overview WEI Wenbin Guidance Beijing Tongren Hospital, Capital Medical University / Beijing Tongren Eye Center / Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment / Beijing Ophthalmology&Visual Sciences Key Lab / Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing 100730, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 5-10.
[2] Ocular ischemic syndrome(OIS)is usually undiagnosed or misdiagnosed due to its asymptomatic onset, complicated ocular manifestations, and the lack of awareness, and patients with OIS have a higher mortality. Improving the understanding, diagnosis, and treatment of OIS through multidisciplinary collaboration is key to investigating and preventing systemic vascular events as well as decreasing blindness and mortality. This review summarizes the recent advances in the epidemiology, clinical diagnosis, and management of OIS.. Recent ocular ischemic syndrome advancesWANG Luping Overview HUANG Yingxiang, WANG Yanling Guidance Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 23-27.
[3] ObjectiveTo compare the effects of intra-arterial thrombolysis and traditional treatment in central retinal artery occlusion(CRAO). MethodsWe searched the Pubmed, Embase, Clinical.gov, CNKI, and Wan Fang databases for related studies that were published up to May 14, 2020. We included clinical controls that compared intra-arterial thrombolysis and conventional treatment in CRAO. The random effect model and R software were used for data analysis. ResultsWe identified seven studies including 563 CRAO patients. Meta-analysis results of two randomized controlled trials(RCTs)showed that there was no significant difference in visual acuity improvement between CRAO patients treated with arterial thrombolysis therapy and those with conventional therapy(RR: 1.17, 95% confidence interval 0.80-1.72, P=0.409). Meta-analysis results of five cohort studies indicated that compared with conventional therapy, arterial thrombolysis therapy significantly improved visual acuity(RR: 1.86, 95% confidence interval 1.43-2.41, P<0.001). The difference between thrombolysis therapy and conventional therapy may be caused by the different treatment time windows in patients. Concerning the adverse reactions after treatment, two RCTs and five cohort studies showed that the adverse reactions in the thrombolysis group are significantly higher than those in the conventional treatment group. ConclusionAlthough intra-arterial thrombolysis therapy has therapeutic potential in CRAO patients, there is still insufficient clinical evidence to prove its effectiveness and safety. Further studies with a large sample and high quality RCTs are required.. Intra-arterial thrombolysis for central retinal artery occlusion: a Meta-analysisCHEN Xi, LI Shanshan, ZHAO Lu, YOU Ran, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 28-34.
[4] ObjectiveTo discuss the causes and appropriate treatment for iris neovascularization following the analysis of 25 cases(28 eyes). MethodsIt was a retrospective case series study involving 25 patients(28 eyes)with iris neovascularization diagnosed between September 2014 and July 2016. All the patients underwent ophthalmic examination, and all the examination findings and treatments were recorded. The causes, correlative factors, and treatment outcomes of iris neovascularization were analyzed. ResultsOf the patients, 17(20 eyes, 71.4%)had retinal ischemic signs, including vitreous hemorrhage and retinal vascularization on fundus fluorescein angiography; 8(8 eyes, 28.6%)did not have retinal ischemic signs. After 3 months of treatment, retinal vascularization resolved in all the cases, and iris neovascularization resolved completely in 20 patients(23 eyes, 82.1%), iris neovascularization was still found in 5 patients(5 eyes, 17.9%). ConclusionsAnterior segment ischemia may also lead to iris vascularization, although retinal ischemia was the main cause. Additionally, iris neovascularization may not always resolve with treatment for retinal ischemia. Finally, anti-VEGF drug injection was an effective treatment for iris neovascularization.. Case analysis of 25 cases of iris neovascularizationLI Xuan1,2, HUANG Yingxiang2 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2. Department of Fundus Disease and Eye Trauma, Eye Hospital China Academy of Chinese Medicine Sciences, Beijing 100040, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 41-47.
[5] Spectral-domain optical coherence tomography(SD-OCT)was used to measure and observe the characteristics of the subfoveal choroidal thickness(SFCT)in patients with ocular ischemic syndrome(OIS)as well as explore the indicators for early evaluation of OIS. MethodsThis was a retrospective case-control study. Forty-eight patients(48 eyes)were included between January 2017 and January 2020. The patients were divided into two groups: the OIS and the control groups, with each consisting of 24 patients(24 eyes). Their basic information, including age, gender, body mass index(BMI), and the history of diabetes, hypertension, and hyperlipidemia, was collected. SFCT was measured using SD-OCT in EDI mode. The basic data and SFCTs of the two groups were compared. ResultsThere were no significant differences between the ages, gender, BMIs, and the prevalence of diabetes, hypertension, and hyperlipidemia of the two groups(all P>0.05). The mean SFCT of the OIS group was 204.83±27.34 μm, and that of the control group was 226.58±33.49 μm. The differences between the two groups were statistically significant(t=2.464, P=0.018). ConclusionsSFCT was thinner in patients with OIS. SFCT can be used as an indicator for early assessment of OIS.. Analysis of choroidal thickness in patients with ocular ischemic syndromeFU Qiang, WANG Hongxing Department of Ophthalmology, Beijing Chuiyangliu Hospital, Beijing 100022, ChinaAbstract: Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 60-63.
[6] To analyze the changes in the neurons of the retinal inner nuclear layer and in the visual function of rat models with ocular ischemia syndrome. MethodsAt the age of 8 weeks, Brown-Norway rats underwent bilateral common carotid artery occlusion(BCCAO)surgery as the model of ocular ischemia syndrome. After 1 and 2 months since the model was established, the retinal thickness was measured in eyeball slices. By applying immunofluorescence, changes in the morphology and synaptic plasticity of horizontal and bipolar cells in the retinal inner nuclear layer were observed. Changes in the visual function of rats were detected by electrophysiology. ResultsWith prolongation of the retinal ischemia time, the number of cells in each retinal layer decreased, and thicknesses of the inner and outer plexiform layers also decreased. Dendrites of horizontal and bipolar cells decreased or disappeared. The density of presynaptic membrane marker synaptophysin decreased. After 2 months since the modeling, the somatic positions of horizontal and bipolar cells migrated from the outer side to the basal side of the inner nuclear layer and formed new neurites. Synaptophysin was randomly distributed in the outer nuclear layer. Electrophysiology showed markedly reduced a- and b-wave amplitudes in BCCAO rats, indicating that the visual function of the BCCAO rats was impaired, and various retinal cell functions were affected. ConclusionIn rat models with ocular ischemia syndrome, the thickness of retinal layers and number of retinal cells decreased. Two months after the model was established, horizontal and bipolar cells migrated, and synaptic rewiring occurred, resulting in retinal remodeling.. Changes in the neural plasticity of neurons and retinal remodeling in the retinal inner nuclear layer of an ocular ischemic syndrome rat model CHEN Xi, LI Shanshan, YOU Ran, ZHAO Lu, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, 100050Abstract: Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 80-86.
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