망막혈관폐쇄 질환에서 경동맥초음파로 측정된 내중막두께
The Intima Media Thickness (IMT) as Measured by Carotid Ultrasonography in Patients with Retinal Vascular Diseases
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목적: 망막혈관질환 환자들의 경동맥 초음파 소견을 알아보고 심혈관계 질환의 위험도 및 연관관계를 알아보고자 한다. 대상과 방법: 본원에서 2009년 12월부터 2012년 12월까지 중심동맥폐쇄(CRAO, n=18), 중심정맥폐쇄(CRVO, n=23), 분지정맥폐쇄(BRVO, n=68)로 진단 받은 환자를 대상으로 경동맥 초음파를 통해 총경동맥(CCA)과 내경동맥(ICA)의 내중막두께(IMT), 혈관협착(stenosis)의 유무, 죽상판(plaque)의 수를 측정하여 건강한 대조군(n=221)과 비교하였다. 결과: 평균 CCA-IMT, ICA-IMT 모두 대조군과 비교해서 CRAO, BRVO군에서 유의하게 증가되어 있었다. 병변 반대측 CCA-IMT는CRAO, BRVO, CRVO군에서, ICA-IMT는 CRAO, BRVO군에서 대조군에 비해 증가되어 있었다. CCA stenosis는 CRVO 병변 반대측(9.1%)에서, ICA stenosis는 CRAO병변측(21.7%)에서 유의한 결과를 보였다. 죽상판은 모든 군에서 대조군에 비해 많이 관찰되었다. IMT가 1.0 mm 이상으로 두꺼워진 심혈관계 질환의 위험군 비율은 CRAO, BRVO군에서 대조군에 비해 높았다. 결론: 망막혈관질환 환자들의 경동맥초음파 소견에서 IMT증가와 죽상판의 증가를 관찰할 수 있었고, IMT로 정의한 심혈관계 위험군비율이 높은 것을 알 수 있었다. 따라서 망막혈관질환 환자들에서 경동맥 초음파 검사를 시행하여 심혈관계 질환의 전반적인 관리와치료가 필요할 것으로 생각한다.
Abstract
Purpose: To evaluate the findings of carotid ultrasonography performed on patients with retinal vascular disease and to determinethe risk of cardiovascular disease and association of retinal vascular disease and cardiovascular disease. Methods: From December 2009 to May 2012, patients diagnosed with central retinal artery occlusion (CRAO, n = 18), centralretinal vein occlusion (CRVO, n = 23), and branch retinal vein occlusion (BRVO, n = 68) underwent carotid ultrasonography. Weevaluated the intima-media thickness (IMT) of the common carotid artery (CCA) and the internal carotid artery (ICA), stenosisand the number of plaques, and then compared these results with those of a healthy control group (n = 221). Results: The mean CCA-IMT and ICA-IMT were significantly higher in the CRAO and BRVO groups compared with the controlgroup. On the contralateral side, CCA-IMT was increased in the CRAO, BRVO, and CRVO groups and ICA-IMT was increasedin the CRAO and BRVO groups compared with the control group. Contralateral CCA stenosis was higher in the CRVOgroup (9.1%) and ipsilateral ICA stenosis in CRAO group (21.7%) was significantly higher than that of the control group. Plaque was observed better in all groups compared with the control group. The proportion of patients risk for cardiovasculardisease, i.e. those who had IMT thickenesses more than 1.0 mm, was higher in the CRAO and BRVO groups compared withthe control group. Conclusions: The carotid ultrasound findings of patients with retinal vascular diseases showed increased IMT and plaque. Thegroup of patient at risk for cardiovascular disease, which was defined with carotid artery IMT, was higher in patients with retinalvascular disease. Therefore, in patients with retinal vascular disease, carotid artery ultrasonography and the overall managementand treatment of cardiovascular disease are necessary.
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