How retinal artery occlusion reveals moyamoya disease-a case series and descriptive study.

IF 2 4区医学 Q2 OPHTHALMOLOGY

International journal of ophthalmology Pub Date : 2026-09-18 eCollection Date: 2026-01-01 DOI:10.18240/ijo.2026.09.12

Zi-Yue Li, Ying Li, Ya-Qi Wang, Ting Chen, Xuan Xiao

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引用次数: 0

Abstract

Aim: To systematically characterize the clinical features, correlations, and therapeutic implications of participants with moyamoya disease (MMD)-related retinal artery occlusion (RAO) through a case series and pooled descriptive analysis.

Methods: A total of 9 participants with MMD-RAO (2020-2025) and 9 cases retrieved from published literature (1981-2025) were retrospectively reviewed to descriptively explore the association between MMD and RAO. Mean difference (MD) was adopted as the effect size for continuous variables, while odds ratio (OR) was used for categorical variables. Heterogeneity was evaluated using the Q statistic and I ² index. Publication bias was assessed via funnel plots, and sensitivity analysis was performed using the leave-one-out method.

Results: Eighteen participants were enrolled in the final analysis, with a male predominance (male:female=1.25:1). Limited improvement in best-corrected visual acuity (BCVA) was observed after treatment (logMAR range: 0.22-3.0). Central retinal artery occlusion (CRAO) was the predominant subtype (83.3%), followed by branch retinal artery occlusion (BRAO, 11.1%) and cilioretinal artery occlusion (CLRAO, 5.6%). Participants in our institutional cohort were significantly older than those reported in literature (52.89±9.53 vs 25.56±12.58y, P<0.001). Our cohort presented slightly worse initial BCVA (2.04±0.9 vs 1.90±0.68; MD=0.14, 95%CI: -0.60-0.88, P=0.711, I ²=78.3%) and inferior visual recovery (1.99±0.9 vs 1.22±1.14; MD=0.77, 95%CI: -0.19-1.73, P=0.132, I ²=82.5%), whereas complete visual recovery (logMAR=0.1) was documented in one BRAO case from published reports. The efficacy of intra-arterial thrombolysis (IAT) reached 60% (3/5) in our cohort, and the overall rate of visual improvement was 41.2%. Mild publication bias was detected; however, sensitivity analysis verified the robustness of primary results.

Conclusion: Participants with MMD-related RAO exhibit unique clinical characteristics differing from those with isolated RAO or uncomplicated MMD. This study identifies an "older MMD phenotype" complicated by RAO, and highlights the necessity of comprehensive vascular screening in elderly participants presenting with RAO to facilitate timely combined ophthalmological and neurological intervention.

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视网膜动脉闭塞如何揭示烟雾病——病例系列和描述性研究。

目的：通过病例系列和汇总描述性分析，系统地描述烟雾病（MMD）相关视网膜动脉闭塞（RAO）患者的临床特征、相关性和治疗意义。方法：回顾性分析9例MMD-RAO患者（2020-2025）和9例已发表文献（1981-2025），探讨MMD与RAO之间的关系。连续变量效应大小采用均值差（MD），分类变量效应大小采用比值比（OR）。采用Q统计量和i2指数评价异质性。通过漏斗图评估发表偏倚，使用留一法进行敏感性分析。结果：最终分析纳入18名受试者，以男性为主（男：女=1.25:1）。治疗后最佳矫正视力（BCVA）改善有限（logMAR范围：0.22-3.0）。视网膜中央动脉闭塞（CRAO）是主要亚型（83.3%），其次是视网膜分支动脉闭塞（BRAO），占11.1%，其次是睫状视网膜动脉闭塞（CLRAO），占5.6%。我们机构队列的参与者明显比文献报道的年龄大（52.89±9.53 vs 25.56±12.58,pv vs 1.90±0.68；MD=0.14, 95%CI: -0.60-0.88， P=0.711, i2 =78.3%），视力恢复较差（1.99±0.9 vs 1.22±1.14；MD=0.77, 95%CI: -0.19-1.73， P=0.132, i2 =82.5%），而在已发表的报告中，有1例BRAO病例的视力完全恢复（logMAR=0.1）。在我们的队列中，动脉内溶栓（IAT）的有效率达到60%(3/5)，总体视力改善率为41.2%。轻度发表偏倚；然而，敏感性分析验证了主要结果的稳健性。结论：烟雾相关的RAO患者表现出独特的临床特征，不同于单纯的RAO或无并发症的烟雾病患者。本研究确定了一种由RAO合并的“老年烟雾病表型”，并强调了对出现RAO的老年参与者进行全面血管筛查的必要性，以促进及时的眼科和神经学联合干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of ophthalmology Medicine-Ophthalmology

CiteScore

2.50

自引率

7.10%

发文量

3141

审稿时长

4-8 weeks

期刊介绍： · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.