Abstract：
Current modalities for diagnosing carotid cavernous fistula (CCF) are inaccurate in analysing retinal microcirculations and nerve fibre changes. Retinal microvascular and neural alterations occur in CCF patients and can be quantitatively measured using optical coherence tomography angiography (OCTA). We measured the neurovascular changes in the eyes of CCF patients and used OCTA as a supplementary method.
This cross-sectional study studied 54 eyes of 27 unilateral CCF subjects and 54 eyes of 27 healthy age- and sex-matched controls. OCTA parameters in the macula and optic nerve head (ONH) were analysed using a one-way analysis of variance with further Bonferroni corrections. Parameters with statistical significance were included in a multivariable binary logistic regression analysis and receiver operating characteristic (ROC) curves were generated.
There was significantly less deep-vessel density (DVD) and ONH-associated capillary density in both eyes of CCF patients than in controls, while the differences between the affected and contralateral eyes were insignificant. The retinal nerve fibre layer and ganglion cell complex thickness were lower in the affected eyes than in the contralateral or controlled eyes. ROC curves identified DVD and ONH-associated capillary density as significant parameters in both eyes of CCF patients.
The retinal microvascular circulation was affected in both eyes of unilateral CCF patients. Microvascular alterations occurred before retinal neural damage. This quantitative study suggests a supplementary measurement for diagnosing CCF and detecting early neurovascular impairments.
This cross-sectional study studied 54 eyes of 27 unilateral CCF subjects and 54 eyes of 27 healthy age- and sex-matched controls. OCTA parameters in the macula and optic nerve head (ONH) were analysed using a one-way analysis of variance with further Bonferroni corrections. Parameters with statistical significance were included in a multivariable binary logistic regression analysis and receiver operating characteristic (ROC) curves were generated.
There was significantly less deep-vessel density (DVD) and ONH-associated capillary density in both eyes of CCF patients than in controls, while the differences between the affected and contralateral eyes were insignificant. The retinal nerve fibre layer and ganglion cell complex thickness were lower in the affected eyes than in the contralateral or controlled eyes. ROC curves identified DVD and ONH-associated capillary density as significant parameters in both eyes of CCF patients.
The retinal microvascular circulation was affected in both eyes of unilateral CCF patients. Microvascular alterations occurred before retinal neural damage. This quantitative study suggests a supplementary measurement for diagnosing CCF and detecting early neurovascular impairments.
摘要：
背景：目前诊断颈动脉海绵窦瘘（CCF）的方法在分析视网膜微循环和神经纤维变化方面不准确。视网膜微血管和神经改变发生在CCF患者中，可以使用光学相干断层扫描血管造影（OCTA）进行定量测量。我们测量了CCF患者眼睛的神经血管变化，并使用OCTA作为补充方法。
方法：这项横断面研究研究了27名单侧CCF受试者的54只眼和27名年龄和性别匹配的健康对照者的54只眼。使用单向方差分析并进一步进行Bonferroni校正，分析了黄斑和视神经头（ONH）的OCTA参数。具有统计学意义的参数包括在多变量二元逻辑回归分析中，并生成受试者工作特征（ROC）曲线。
结果：CCF患者双眼的深血管密度（DVD）和ONH相关毛细血管密度明显低于对照组，而患侧和对侧眼睛之间的差异微不足道。受影响的眼睛的视网膜神经纤维层和神经节细胞复合物厚度低于对侧或受控眼睛。ROC曲线将DVD和ONH相关的毛细血管密度确定为CCF患者双眼的重要参数。
结论：单侧CCF患者的双眼视网膜微血管循环受到影响。微血管改变发生在视网膜神经损伤之前。这项定量研究提出了诊断CCF和检测早期神经血管损伤的补充措施。
方法：这项横断面研究研究了27名单侧CCF受试者的54只眼和27名年龄和性别匹配的健康对照者的54只眼。使用单向方差分析并进一步进行Bonferroni校正，分析了黄斑和视神经头（ONH）的OCTA参数。具有统计学意义的参数包括在多变量二元逻辑回归分析中，并生成受试者工作特征（ROC）曲线。
结果：CCF患者双眼的深血管密度（DVD）和ONH相关毛细血管密度明显低于对照组，而患侧和对侧眼睛之间的差异微不足道。受影响的眼睛的视网膜神经纤维层和神经节细胞复合物厚度低于对侧或受控眼睛。ROC曲线将DVD和ONH相关的毛细血管密度确定为CCF患者双眼的重要参数。
结论：单侧CCF患者的双眼视网膜微血管循环受到影响。微血管改变发生在视网膜神经损伤之前。这项定量研究提出了诊断CCF和检测早期神经血管损伤的补充措施。
