網膜血管閉塞症における足関節上腕血圧比(ABI)と脈波速度(PWV)の臨床的意義 CLINICAL SIGNIFICANCE OF THE ANKLE-BRACHIAL INDEX (ABI) AND PULSE WAVE VELOCITY (PWV) IN PATIENTS WITH RETINAL VASCULAR OCCLUSION

目的:網膜血管閉塞症における足関節上腕血圧比(ankle-brachial index: ABI)と脈波速度(pulse wave velocity: PWV)の臨床的意義について報告する.対象と方法:網膜血管閉塞症,高血圧網膜症および糖尿病網膜症患者106例と年齢・性別をマッチさせた健常対照者100例を対象に,動脈硬化の指標であるABIおよびPWVを測定し,病態との関連につき検討した.結果:網膜血管閉塞症を有する患者では加齢によりABI値の減少がみられたが,他の網膜血管疾患患者や対照者ではみられなかった.ABI値は三眼疾患すべてを合併している患者では他の患者に比べて有意に低かった.また,ABI値が0.9以下の異常値を示した6例中5例は網膜中心動脈閉塞症を発症または発症していた.一方,PWV値は疾患間で差はみられなかった.結論:今回の結果はABI値が網膜血管閉塞症特に網膜中心動脈閉塞症の臨床マーカーとなり得ることを最初に示した研究である.

Purpose: To report the clinical significance of ankle-brachial index (ABI) and pulse wave velocity (PWV) in retinal vascular occlusion. Method: We measured the ABI and PWV, which are used as clinical indicators of arteriosclerosis, of 106 patients with retinal vascular occlusion (RVO) as well as hypertensive retinopathy (HR) and diabetic retinopathy (DR), and 100 age-matched healthy control subjects. Results: ABI decreased with advancing age in patients with RVO, whereas no age-related changes were observed in non-RVO patients and control subjects. Furthermore, ABI was significantly lower in patients having combined presence of HR, DR and RVO than it was in patients with either HR, DR, RVO, HR+DR, HR+RVO or DR+RVO. Five out of six patients with abnormally low ABI values (less than 0.9) had associated central retinal artery occlusion (CRAO). In contrast, no such associations were observed in PWV among the groups. Conclusion: Our present data provide the first evidence that measurement of ABI may be a clinical marker for management for retinal vascular occlusion, especially for CRAO.