Koroner arter hastalığı-retina ilişkisi
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Date
2010
Authors
Doğan, Tolga
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Kardiyovasküler hastalıkların tedavisindeki devam eden gelişmelere rağmen bu hastalıkların mortalitesi hala yüksektir. Retinal mikrovasküler anormallikler, hipertansiyon, ateroskleroz, yaşlanma ve diğer süreçlerin sonucu olarak meydana gelen kümülatif mikro sirkülatuvar hasarı yansıtır ve mikrovasküler patolojiler ile kardiyovasküler hastalıkların arasındaki ilişkiyi noninvaziv biçimde araştırılmasını sağlar.Çalışmada koroner anjiyografisi yapılan ve koroner arter hastalığı tanısı alan yüz hastanın bilateral göz dibi muayenesi yapıldı. Çalışmanın amacı, hastaların koroner arter risk faktörleri ile karotis intima media kalınlıklarını, biyokimyasal kan değerleriyle beraber göz dibi muayene bulgularını değerlendirmek idi. Böylelikle invaziv olmayan göz dibi muayenesinin, yüksek riskli hastaların belirlenmesindeki etkinliğinin araştırılması hedeflenmekteydi.Hastaların yaş ortalaması 58,25 ± 7,1 olup, çalışma popülasyonu 72 (%72) erkek ile 28 (%28) kadın hastadan oluşmakta idi. Hipertansiyon, hiperlipidemi ve obezite yüksek oranda idi. %70 hasta hipertansif olarak saptanırken, sigara içicilerin sayısı yirmi bir (%21), ailede erken KAH öyküsü olanların oranı ise %22 idi.Göz dibi muayenesi sonrası hastaların %87'sinde (62 erkek, 25 kadın) aterosklerotik değişikler saptandı. Scheie sınıflamasına göre hastaların %54'ünde Evre I ateroskleroz (15 kadın, 39 erkek) , %32'sinde Evre II ateroskleroz (10 kadın, 22 erkek) ve %1'inde (erkek hasta) Evre III ateroskleroz varlığı belirlendi. Göz dibi bulgularından olan druzenoid cisimcikler klopidogrel kullanmayan hastalarda klopidogrel kullananlara göre istatistiksel olarak daha fazla idi (p<0.001). Retinal tortiosite artışı hastaların %65'inde mevcut idi. 3 hastada da Hollenhorst bulgusu izlendi.Sonuç olarak göz dibi muayenesi, kardiyak fonksiyonlarının değerlendirilmesinde kullanılabilen, invaziv olmayan ve kolay uygulanabilen bir muayene yöntemidir.
In spite of the ongoing developments in the treatment of cardiovascular diseases those diseases still have high mortality. Retinal microvascular abnormalities reflect micro-circulatory cumulative damage caused by hypertension, atherosclerosis, aging and other processes and allows noninvasive way to investigate relationship between microvascular pathology and cardiovascular disease. In the study, bilateral ocular fundus examination was performed to a group consisting a hundred patients who has coronary artery disease assessed by coronary angiography. The aim of the study was to evaluate the fundus examination findings with risk factors for coronary artery disease, carotid intima media thickness, and biochemical blood values together. Thus, the aim of the study was set to investigate the efficacy of a non-invasive method; fundus examination to identify high risk patients. The mean age of patients was 58.25 ± 7.1, 72 (72%) people were male and 28 (28%) were female. Hypertension, hyperlipidemia and obesity were common among the study population. While the 70% of the patients were found to be hypertensive, number of smokers was 21 (21%) and the number of patients who have a family history for early CAD was 22%. By using the fundus examination, atherosclerotic changes was identified in 87% of patients (62 males, 25 females). According to the Scheie classification, grade I atherosclerosis was present in 54% (15 female, 39 male), grade II atherosclerosis in 32% (10 female, 22 male) and grade III atherosclerosis in 1% (1 male) of the patients. Druzenoid bodies, one of the fundus examination finding, was statistically more frequent in clopidogrel user patients than clopidogrel non-users (p<0.001). Retinal tortuosity was present in 65 % of patients. Hollenhorst sign were observed in three patients. In summary, fundus examination is easily applicable and noninvasive method for evaluation of cardiac function.
In spite of the ongoing developments in the treatment of cardiovascular diseases those diseases still have high mortality. Retinal microvascular abnormalities reflect micro-circulatory cumulative damage caused by hypertension, atherosclerosis, aging and other processes and allows noninvasive way to investigate relationship between microvascular pathology and cardiovascular disease. In the study, bilateral ocular fundus examination was performed to a group consisting a hundred patients who has coronary artery disease assessed by coronary angiography. The aim of the study was to evaluate the fundus examination findings with risk factors for coronary artery disease, carotid intima media thickness, and biochemical blood values together. Thus, the aim of the study was set to investigate the efficacy of a non-invasive method; fundus examination to identify high risk patients. The mean age of patients was 58.25 ± 7.1, 72 (72%) people were male and 28 (28%) were female. Hypertension, hyperlipidemia and obesity were common among the study population. While the 70% of the patients were found to be hypertensive, number of smokers was 21 (21%) and the number of patients who have a family history for early CAD was 22%. By using the fundus examination, atherosclerotic changes was identified in 87% of patients (62 males, 25 females). According to the Scheie classification, grade I atherosclerosis was present in 54% (15 female, 39 male), grade II atherosclerosis in 32% (10 female, 22 male) and grade III atherosclerosis in 1% (1 male) of the patients. Druzenoid bodies, one of the fundus examination finding, was statistically more frequent in clopidogrel user patients than clopidogrel non-users (p<0.001). Retinal tortuosity was present in 65 % of patients. Hollenhorst sign were observed in three patients. In summary, fundus examination is easily applicable and noninvasive method for evaluation of cardiac function.
Description
Keywords
Ateroskleroz, Kardiyovasküler hastalıklar, Göz dibi muayenesi, Druzenoid cisimcikler, Atherosclerosis, Cardiovascular diseases, Ocular fundus examination, Druzenoid bodies
Citation
Doğan, T. (2010). Koroner arter hastalığı-retina ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.