Venous Nicking Without Arteriovenous Contact The Role of the Arteriolar Microenvironment in Arteriovenous Nickings
Venous Nicking Without Arteriovenous Contact The Role of the Arteriolar Microenvironment in Arteriovenous Nickings
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DOI：
10.1001/jamaophthalmol.2015.1132
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发表时间：
2015-08-01
影响因子：
8.1
通讯作者：
Girmens, Jean-Francois
中科院分区：
文献类型：
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作者：
Paques, Michel;Brolly, Aurelie;Girmens, Jean-Francois
视网膜动静脉切迹（AVN）是视网膜静脉阻塞的原因，也是脑血管老化的替代物。尽管缺乏眼底照片以外的证据，但动脉挤压静脉的AVN流行机制模型仍然没有受到挑战。在这里，我们观察到，静脉切口可以观察到在没有物理接触的情况下与arteriole.OBSERVATIONS这项观察性研究，从2013年1月至2014年9月进行，包括7例患者显示重塑的静脉段接近视网膜小动脉没有动静脉重叠成像自适应光学成像。受影响的静脉节段表现出不同的相关性，切口，狭窄，偏差，和浑浊。7例中6例静脉段偏向小动脉。静脉狭窄的程度范围从40%到77%，而在这些网站，血管间隙的宽度范围从16 μ m到42 μ m。结论和相关性动静脉切口不一定涉及动静脉压迫.相反，静脉变化的拓扑结构表明血管间隙起源的回缩过程。这些发现对于理解视网膜静脉阻塞和脑血管老化有重要意义。
IMPORTANCE Arteriovenous nickings (AVNs) in the retina are the cause of retinal vein occlusions and are also surrogates of cerebrovascular aging. The prevalent mechanistic model of AVNs stating that arteries crush veins remains somewhat unchallenged despite the lack of evidence other than fundus photographs. Here, we observed that venous nicking may be observed in the absence of physical contact with an arteriole.OBSERVATIONS This observational study, conducted from January 2013 to September 2014, included 7 patients showing remodeling of a venous segment close to a retinal arteriole without arteriovenous overlap were imaged by adaptive optics imaging. Affected venous segments showed a variable association of nicking, narrowing, deviation, and opacification. Venous segments were deviated toward the arterioles in 6 of the 7 cases. The degree of venous narrowing ranged from 40% to 77%, while at these sites, the width of the intervascular space ranged from 16 mu m to 42 mu m. Similar featureswere identified in typical AVNs.CONCLUSIONS AND RELEVANCE Arteriovenous nickings do not necessarily involve an arteriovenous compression. Instead, the topology of venous changes suggests a retractile process originating in the intervascular space. These findings have important implications for the understanding of retinal vein occlusions and of cerebrovascular aging.