眼底成像揭示视觉偏头痛的相关神经血管病变  

Fundus imaging reveals relevant neurovascular pathology in visual migraine

作　　者：薛海娜 惠延年 张鹏[1] Hai-Na Xue;Yan-Nian Hui;Peng Zhang(Xi'an No.3 Hospital,The Affiliated Hospital of Northwest University,Xi'an 710018,Shaanxi Province,China;Department of Ophthalmology,Xijing Hospital,Eye Institute of Chinese PLA,Fourth Military Medical of University,Xi'an 710032,Shaanxi Province,China)

机构地区：[1]西北大学附属医院西安市第三医院,中国陕西省西安市710018 [2]空军军医大学西京医院眼科全军眼科研究所,中国陕西省西安市710032

出　　处：《国际眼科杂志》2022年第6期973-976,共4页International Eye Science

摘　　要：偏头痛是一种常见的慢性神经血管疾病,其病理生理机制尚不明确。偏头痛有多种临床表型,其中视觉偏头痛可表现为视觉先兆。视网膜偏头痛和眼麻痹性偏头痛也属于视觉偏头痛的范畴。光学相干断层扫描(OCT)及血管成像(OCTA)可以定性及定量地检测视网膜神经纤维层、神经节细胞层、视神经乳头、视网膜和脉络膜的循环状况。基于上述两种影像学的研究发现,在视觉偏头痛发病过程中,偏头痛患者的视网膜和睫状动脉短暂反复收缩,可能导致视神经、视网膜和脉络膜的缺血性损伤,随后视网膜神经纤维层及神经节细胞层变薄、视网膜微血管减少。眼底影像学检查有助于提高对视觉偏头痛相关病理生理学机制的认知,而基于OCT及OCTA检查所见可作为评估视觉偏头痛病程及病情严重程度的指标。Migraine is acommon chronic neurovascular disorder,its pathophysiological mechanisms are not fully understood.There are various clinical phenotypes of migraine,among which visual migraine may present as visual aura.Retinal migraine and ophthalmoplegic migraine also belong to the category of visual migraine.Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)can be used to detect the circulation of retinal nerve fiber layer,ganglion cell layer,optic papilla,retina and choroid qualitatively and quantitatively.Based on above two imaging findings,studies have addressed that during visual migraine pathogenesis,the transitory and recurrent constriction of the retinal and ciliary arteries,which may cause ischemic damage to the optic nerve,retina and choroid in patients with migraine,with the subsequent reduction in thickness of retinal nerve fiber layer,ganglion cell layer,and retinal microvasculature decrement.The fundus imaging examinations are helpful to improve our understanding on pathophysiological mechanisms of visual migraine,these imaging findings based on OCT and OCTA may serve as indicators to evaluate course and severity of visual migraine.

关 键 词：偏头痛 光学相干断层扫描 视网膜神经纤维层 视网膜 脉络膜 

分 类 号：R74[医药卫生—神经病学与精神病学]