颈动脉狭窄患者 OCTA 检测到的视网膜血管指标：系统综述和荟萃分析。

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2024-11-01 DOI:10.1016/j.pdpdt.2024.104390

Kaibao Ji , Yang Yang , Yiqiao Xing, Wei Wan

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引用次数: 0

摘要

背景：颈动脉狭窄（CAS）是导致脑微循环功能障碍的主要原因，占缺血性脑卒中的 15-20%。视网膜血管的变化与包括 CAS 在内的多种全身性疾病有关。这篇系统性综述研究了使用光学相干断层血管成像（OCTA）测量 CAS 患者视网膜微血管的变化：我们全面检索了电子数据库，即 PubMed、Cochrane Library、Embase 和 Web of Science。将 CAS 患者的黄斑和视神经头血管密度（VD）与对照组进行比较。每项结果的汇总数据均计算为标准化均值差异（SMD）和95%置信区间。OCTA参数使用Review Manager 5.4.1版软件进行分析：本次荟萃分析共纳入七篇文章。CAS患者的整个黄斑表面和深层VD明显低于对照组（分别为SMD = -0.97，P = 0.002；SMD = -1.05，P = 0.006）。此外，CAS 组眼底浅层 VD 明显低于健康组（SMD= -0.71，P= 0.001）。与健康人相比，CAS患者的径向毛细血管周围（RPC）全像VD（SMD= -0.90，P< 0.0001）、RPC盘内VD（SMD= -0.49，P= 0.02）和RPC毛细血管周围VD（SMD= -0.64，P= 0.0003）也明显较低：这些研究结果表明，CAS 患者的黄斑和视神经头区域的 VD 很容易降低。因此，OCTA 显示出作为早期检测 CAS 引起的脑微循环障碍的工具的潜力。

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Metrics of retinal vasculature detected on OCTA in carotid artery stenosis: A systematic review and meta-analysis

Background

Carotid artery stenosis (CAS) is a major cause of cerebral microcirculation dysfunction, contributing to 15–20% of ischemic strokes. Retinal vessel changes is associated with several systemic diseases, including CAS. This systematic review investigates retinal microvascular alterations measured using optical coherence tomography angiography (OCTA) in patients with CAS.

Methods

We comprehensively searched the electronic databases, namely PubMed, Cochrane Library, Embase, and Web of Science. Macular and optic nerve head vascular density (VD) in patients with CAS were compared to controls. Pooled data for each outcome were calculated as standardized mean difference (SMD) and 95% confidence interval. OCTA parameters were analyzed using Review Manager Version 5.4.1 software.

Results

Seven articles were included in this meta-analysis. Whole macular enface superficial and deep VD were significantly lower in patients with CAS than in controls (SMD = -0.97, P = 0.002; SMD = -1.05, P = 0.006, respectively). Additionally, the parafoveal superficial VD was significantly lower in the CAS group than in the healthy group (SMD = -0.71, P= 0.001). Radial peripapillary capillary (RPC) whole-image VD (SMD = -0.90, P< 0.0001), RPC inside disc VD (SMD = -0.49, P = 0.02), and RPC peripapillary VD (SMD = -0.64, P = 0.0003) were also significantly lower in patients with CAS compared to healthy individuals.

Conclusion

These findings suggest that patients with CAS are prone to decreased VD in the macular and optic nerve head areas. Hence, OCTA shows potential as a promising tool for the early detection of cerebral microcirculation disorders due to CAS.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.