Retinal microvasculature is a potential biomarker for acute mountain sickness  

作　　者：Yuan Xie Diya Yang Alex S.Huang Yiquan Yang Ying Han Yunxiao Sun Kai Cao Huaizhou Wang Shizheng Wu Qiang Zhu Guozhong Wang Tianyi Wu Ningli Wang 

机构地区：[1]Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology and Visual Sciences Key Laboratory,Beijing,100730,China [2]Beijing Institute of Ophthalmology,Beijing Tongren Hospital,Capital Medical University,Beijing,100005,China [3]The Viterbi Family Department of Ophthalmology,Shiley Eye Institute,University of California,San Diego,CA,92121,USA [4]Department of Ophthalmology,University of California,San Francisco,CA,94143,USA [5]Institution of Geriatric Qinghai Provincial Hospital,Xining,810007,China [6]Department of Ultrasound,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China [7]Department of Hyperbaric and Hypobaric Chamber,Civil Aviation General Hospital,Beijing,100025,China [8]National Key Laboratory of High Altitude Medicine,China High Altitude Medical Research Institute,Xining,810012,China

出　　处：《Science China(Life Sciences)》2023年第6期1290-1302,共13页中国科学（生命科学英文版）

基　　金：supported by the National Natural Science Foundation of China (81271005 and 81300767);Beijing Natural Science Foundation (7122038);Capital Health Research and Development of Special Foundation (ZYLX201501)。

摘　　要：Increased cerebral blood flow resulting from altered capillary level autoregulation at high altitudes leads to capillary overperfusion and then vasogenic cerebral edema,which is the leading hypothesis of acute mountain sickness(AMS).However,studies on cerebral blood flow in AMS have been mostly restricted to gross cerebrovascular endpoints as opposed to the microvasculature.This study aimed to investigate ocular microcirculation alterations,the only visualized capillaries in the central neural system(CNS),during early-stage AMS using a hypobaric chamber.This study found that after high altitude simulation,the optic nerve showed retinal nerve fiber layer thickening(P=0.004–0.018)in some locations,and the area of the optic nerve subarachnoid space(P=0.004)enlarged.Optical coherence tomography angiography(OCTA)showed increased retinal radial peripapillary capillary(RPC)flow density(P=0.003–0.046),particularly on the nasal side of the nerve.The AMSpositive group had the largest increases in RPC flow density in the nasal sector(AMS-positive,?3.21±2.37;AMS-negative,?0.01±2.16,P=0.004).Among multiple ocular changes,OCTA increase in RPC flow density was associated with simulated early-stage AMS symptoms(beta=0.222,95%CI,0.009–0.435,P=0.042).The area under the receiver operating characteristics curve(AUC)for the changes in RPC flow density to predict early-stage AMS outcomes was 0.882(95%CI,0.746–0.998).The results further confirmed that overperfusion of microvascular beds is the key pathophysiologic change in early-stage AMS.RPC OCTA endpoints may serve as a rapid,noninvasive potential biomarker for CNS microvascular changes and AMS development during risk assessment of individuals at high altitudes.

关 键 词：optical coherence tomography ANGIOGRAPHY retinal microvasculature acute mountain sickness 

分 类 号：R594.3[医药卫生—内科学]