The Correlation Research Of Carot Id Artery Stenosis With Retinal Vein Occlusion And Prognosis

Objective:To investigate the correlation of the carotid stenosis and retinal vein occlusion(RVO)in patients with ocular perfusion,understand the occurrence rate of carotid stenosis in the RVO and the relationship between the degree of carotid stenosis and RVO.Analyze the effects of anti VEGF drug treatment of carotid stenosis in RVO secondary macular edemaMethods:This study adopts the prospective study method,the object of study is a total of 18 patients with diagnosis of RVO(18eyes)from October 2016 to December 2017,including 11 males and 7 females,aged from 39 to 86.at the average(66.6 ± 11.2)years,and occurs among the patients,including 10 patients with BRVO(10 eyes),8 patients with CRVO(8 eyes),12 cases in right eyes(12 eyes)and 6 cases in left eves(6 eyes).3 months after treatment,according to the results of FFA,when it is necessary to give full retinal laser photocoagulation or local retinal photocoagulation.but all in the group of patients without macular grid photocoagulation.This group of patients with the inclusion criteria:(1)with blurred vision or decreased vision as the chief complaint.(2)the funduscopic examination and fundus as visible areas of retinal edema,hemorrhage and cotton wool spots,blocking vein circuity expansion,thinner artery.(3)the FFA can have arteries check arm-retinal circulation time prolonged,vein filling time prolonged,the retina with or without blood capillary perfusion area.(4)OCT see disappear in the macular area normal form,retinal edema uplift.Exclusion criteria:retinal vein occlusion patients with diabetic retinopathy,age-related macular degeneration and retinal vascular diseases such as retinal vein inflammation around;Had received a laser,triamcinolone acetonide.anti VEGF drugs;Recent severe systemic disease and can cause systemic diseases including connective tissue disease,retinal vascular lesions such as systemic lupus erythematosus(sle);Refractive stroma serious opacity,cannot observe patients with fundus;Can't cooperate with inspection and follow-up of patients.All eyes into the group of patients were performed best corrected visual acuity(BCVA check adopt international standard eye chart,statistics for minimum resolution conversion Angle when logarithmic(logMAR visual acuity record.Average logMARBCVA patients was 0.96 0.41),intraocular pressure,slit lamp,fundus photography and other routine eye examination,parallel carotid ultrasound examination(including the degree of carotid stenosis,carotid intima-media thickness(IMT));Vascular ultrasound including eyes after double eye artery diameter,the peak systolic velocity(PSV),end-diastolic velocity(EDV),pulse index(PI),resistance index(RI);Central retinal artery diameter and PSV,EDV,PI.RI,macular area EDI model OCT examination(CMT,choroid thickness).The above checks are performed by the same operator in the same instrument.the patient of RVO secondary CME accpect the treatment of eye glass cavity inject 0.05 ml of anti VEGF drugs(Conpercept injection).After treatment,measure CMT and thickness of the choroid.Results:1 8 patients in this study,there are 16 patients suffering from eye side of carotid artery stenosis,88.9%of all patients and side compared with the contralateral eye incidence of carotid stenosis,the difference was statistically significant carotid stenosis is a high risk factor of RVO(P<0.05).CRVO of 8 cases of patients suffering from eye side all have carotid stenosis,8 cases with eyes in 10 patients with BRVO merger of ipsilateral carotid stenosis,BRVO and CRVO two groups of different degree of carotid stenosis patients distribution,the difference was statistically significant(P<0.05).Evaluation of this group of patients with ocular blood perfusion,measure the eyes of 18 patients of ophthalmic artery,central retinal artery PS V,EDV,inner diameter,the index comparison of eye and the healthy eye ophthalmic artery,there were no statistically significant difference(P>0.05).Risk of eye and eye health the index comparison,central retinal artery diameter size only a difference was statistically significant(P<0.05).The central retinal artery diameter of eye side is lower than the healthy eye side.PSV,EDV index has no statistically significant difference(P>0.05)compared with sunken eyes with the healthy eyes of macular center under the choroid thickness,there was no statistically significant difference.Incidence has 10 patients accept glass body cavity anti VEGF drug treatment and postoperative follow-up of 3 months,compaq heap eye ophthalmic injection treatment with carotid stenosis and out patients with carotid stenosis of RVO secondary effect of the treatment of macular edema and the change of the macular thickness of the choroid,there was no statistically significant difference(P>0.05).Incidence in 1 patients diagnosed with ocular ischemia syndrome,parallel carotid surgery.All anti VEGF treated patients does not appear obvious complications,such as elevated iop uncontrollable,vitreous opacity,hemorrhage,retinal RPE tear,endophthalmitis,and so onConclusion:carotid artery stenosis may be one of the cause of RVO.the more serious Carotid stenosis,the poorer ocular blood flow,the more severe the RVO happened.Carotid stenosis factor does not affect the effect of Conbercept on RVO secondary macular edema at the same time also does not affect choroid blood flow change.