颈内动脉狭窄患者视网膜和脉络膜结构改变的Meta分析

Meta analysis of retinal and choroidal structural changes in patients with internal carotid artery stenosis

摘要:

目的：采用Meta分析方法评价光学相干断层扫描(OCT)观察颈内动脉狭窄患者视网膜和脉络膜厚度的变化情况。

方法：检索建库至2024-01中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库(WF)和PubMed、the Cochrane Library、SinoMed、Embase数据库中关于使用OCT对颈内动脉狭窄患者的视网膜和脉络膜结构进行测量的文献。采用纽卡斯尔-渥太华量表(NOS)对纳入文献进行质量评价，应用RevMan 5.4.1和Stata 16.0软件进行统计分析。

结果：纳入文献17篇，包含18项研究。Meta分析结果显示，与健康对照组(与观察组年龄相匹配的正常人群)相比，颈内动脉狭窄患者视盘周围视网膜神经纤维层(pRNFL)、神经节细胞复合体(GCC)、黄斑中心视网膜厚度(CMT)和中心凹下脉络膜厚度(SFCT)明显变薄。与对侧眼比较，颈内动脉狭窄患者同侧眼pRNFL和SFCT变薄。

结论：颈内动脉狭窄在一定程度上会改变视网膜和脉络膜的形态结构。OCT可以无创地检测颈内动脉狭窄患者视网膜和脉络膜的微观结构变化，可用于颈内动脉狭窄的评估。

Abstract:

AIM:To systematically evaluate the changes in retinal and choroidal thickness in patients with internal carotid artery stenosis by using optical coherence tomography(OCT)through Meta-analysis.

METHODS: Literatures on the measurement of retinal and choroidal structure in patients with internal carotid artery stenosis by using OCT from CNKI, VIP, WF, PubMed, the Cochrane Library, SinoMed, and Embase databases were searched for relevant studies. The retrieval time was from the establishment of the databases to January 2024. In addition, quality of the included literatures was assessed by the Newtle-Ottawa scale(NOS), and RevMan 5.4.1 and Stata 16.0 were used for statistical analysis.

RESULTS: A total of 17 articles(including 18 studies)were included, and the Meta-analysis results showed that, patients with internal carotid artery stenosis had significantly thinner peripapillary retinal nerve fiber layer(pRNFL), ganglion cell complex(GCC), center macular thickness(CMT), and subfoveal choroidal thickness(SFCT)than the healthy control group(age matched normal population). The pRNFL and SFCT of the ipsilateral eye in patients with internal carotid artery stenosis become thinner compared with the contralateral eye.

CONCLUSION:To a certain extent, the morphological structure of the retina and choroid can be altered by stenosis of the internal carotid artery. OCT can non-invasively detect the microstructural changes of the retina and choroid in patients with internal carotid artery stenosis, and can be used for the evaluation of internal carotid artery stenosis.