Abstract:

Objective To explore digital fundus photography technology applications in clinical screening of cerebral small vessel disease (CSVD), so as to provide basis for community clinical primary screening of CSVD. Methods A total of 36 cases (72 eyes) of patients who were diagnosed as CSVD from April 2015 to April 2016 were selected as the observation group, and the other 30 cases (60 eyes) of the healthy volunteers who had normal head MRI results in the same time were selected as control group. There were statistical comparisons of general clinical information, fundus changes and carotid plaque between the two groups. Results Compared with control group, in the observation group, incidence of arteriovenous crossing sign (77.78% vs 23.33%), total incidence of fundus changes (88.89% vs 56.67%), and retinal arteriosclerosis grade 3 (30.56% vs 0) were higher (P <0.001, P =0.003, P =0.002). Logistic multivariate regression analysis showed that, arteriovenous crossing sign was an important risk factor of CSVD (odds ratio[OR] 10.678, 95% confidence interval[CI ] 2.943-38.742, P <0.001). In the observation group, the incidence of carotid plaque and the average of carotid plaque of patients with fundus changes (n =32) were higher than that of patients without fundus changes (n =4) (P =0.01, P =0.013). Conclusion In the study, more than half of CSVD patients with arteriovenous crossing sign, and digital ocular fundus photography may be used as one of the CSVD clinical primary screening methods.

Key words: Cerebral small vessel disease; Primary screening; Digital ocular fundus photography; Fundus changes; Carotid plaques

摘要：

目的 探讨数字眼底照相技术在脑小血管病临床初筛中的应用价值，为脑小血管病在基层社区临床 初筛提供依据。 方法 选取脑小血管病患者36例（72眼）为观察组，另选取30例（60眼）同期同年龄层非脑小血管病 的志愿者为对照组。比较两组一般资料、眼底血管改变和颈动脉斑块等情况。 结果 观察组眼底动静脉交叉征率（77.78% vs 23.33%）、眼底血管改变总发生率（88.89% vs 56.67%）、眼底动脉硬化3级比例（30.56% vs 0）均高于对照组（P <0.001，P =0.003，P =0.002）。 Logistic多元回归分析提示眼底动静脉交叉征是脑小血管病的重要危险因素[比值比（odds ratio，OR） 10.678，95%可信区间（confidence interval，CI ）2.943～38.742，P <0.001]。观察组中有眼底血管改变者 32例，无眼底血管改变者4例，有眼底血管改变者的颈动脉斑块发生率、颈动脉斑块数均较无眼底 血管改变者高（P =0.010，P =0.013）。 结论 本研究中半数以上脑小血管病患者出现眼底动静脉交叉征，数字眼底照相技术或可作为脑小 血管病在基层社区临床初筛常规手段之一。

关键词: 脑小血管病; 初筛; 数字眼底照相; 眼底血管改变; 颈动脉斑块。