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本文报导6例病人,均有各种眼部症状如:视野缺损,暂时性视力模糊或盲点等,经眼底镜检查,发现视网膜动脉有胆固醇栓子。该组病人无一例有典型的间歇性视网膜或脑的缺血发作。全部病人全脑动脉造影,均发现有明显的同侧颈动脉病。4例病人接受了颈动脉内膜切除术,从颈动脉分叉处取出了溃疡斑;2例病人同侧颈内动脉完全闭塞,因此无手术指征。自1945年Flory描述,中小动脉的栓子来自动脉粥样硬化斑以来,已公认栓子能从任何动脉粥样硬化斑剥落,并阻塞该动脉远端。暂时性的脑和视网膜缺血发作,也可能是由于来自颈动脉分叉处动脉粥样硬化的小栓子所引起。支持这理论的根据是,当单眼失明发作时,眼底检查可见到病侧的视网膜有栓子。Fisher首先报导了上述发现,他观察到在1
This article reports 6 patients, all kinds of ocular symptoms such as: visual field defects, temporary blurred vision or blind spots, etc., by ophthalmoscopy and found that the retinal artery cholesterol emboli. None of the patients in this group had a typical intermittent retinal or cerebral ischemic attack. All patients with whole cerebral artery angiography, were found to have obvious ipsilateral carotid artery disease. Four patients underwent carotid endarterectomy and ulcerated plaque was removed from the bifurcation of the carotid artery. Two patients had a complete occlusion of the ipsilateral internal carotid artery and were therefore not indicted for surgery. Since 1945 Flory described the emboli of small and medium arteries as being derived from atherosclerotic plaque, it has been recognized that emboli can spall from any atherosclerotic plaque and block the distal end of the artery. Temporary brain and retinal ischemic attacks may also be caused by small emboli from atherosclerotic carotid bifurcation. The rationale for supporting this theory is that when the monocular blind occurs, fundus examination shows that the diseased retina has emboli. Fisher first reported the above findings, which he observed