Karakteristike kolor dopler snimanja kod bolesnika sa okluzijom centralne retinalne arterije sa i bez arteritisa džinovskih ćelija
Sažetak
Uvod. Opstrukcija centralne retinalne arterije (OCRA) predstavlja naglo smanjenje protoka krvi kroz CRA koje može da izazove ozbiljnu ishemiju unutrašnje retine trajnim jednostranim gubitkom vida. Cilj rada bio je da se proceni uloga kolor dopler snimanja (KDI) orbitalnih sudova i ekstrakranijalne dupleks sonografije (EDS) u etiološkoj dijagnostici OCRA. Prikaz bolesnika. Dva bolesnika sa kliničkom sumnjom na jednostrani desni OCRA ispitana su primenom složenog protokola uključujući i KDI orbitalnih sudova. Nisu ustanovljene embolije vidljive na oftalmoskopiji. Na B-sken ultrazvučnoj evaluaciji prvog bolesnika pronađen je mali krug, umereno reflektujući eho unutar desnog očnog živca, 1,5 mm iza optičkog diska. KDI retrobulbarnih krvnih sudova prikazao je normalne hemodinamičke parametre oftalmičke arterije (OA), bez prisustva signala arterijskog protoka na KDI na rastojanju od 1,5 mm iza desnog optičkog diska. Nasuprot tome, levo oko imalo je normalan KDI aspekt retrobulbarnih sudova. Ultrazvučnim pregledom na početnom delu desne a. carotis intenae identifikovana je velika stenoza, kao izvor CRA embolije. Drugi bolesnik imao je karakterističan KDI nalaz za arteritis džinovskih ćelija (GCA) sa učešćem oka: visok indeks otpora u svim retrobulbarnim sudovima (sa izrazitim smanjenjem brzine protoka krvi, posebno end-dijastolne brzine, u pogođenoj desnoj CRA). Bolesnik nije imao sistemske simptome, ni znake GCA. Zaključak. Ultrazvučna dijagnostika omogućuje brzu orijentaciju u pogledu digitalne dijgnoze između OCRA embolijskog mehanizma nastanka i OCRA izazvane prisustvom GCA.
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