engleski

Presence of ischemic retinopathy in patients with advanced carotid stenosis.

In order to examine the influence of internal carotid artery (ICA) advanced stenosis or occlusion on or6ital flow we investigated these patients by means of ophthalmic artery (OA) color Doppler flow imaging (CDFI) and ophthalmic examination. We investigated 22 consecutive patients with advanced carotid stenosis or occlusion, diagnosed by carotid and OA CDFI. History, neurologic examination and ultrasound were obtained. OA were visualised, and angle corrected velocities were measured. Systolic, mean and diastolic blood flow velocities (BF'U) were measured and flow direction was determined. Visual symptoms and ocular background ischemic changes were evaluated. Data of neurologic and ophthalmologic symptoms and findings are presented descriptively. Data of Doppler parameters of affected and non-affected eycs are presented as means and SD and compared by chi square test. In 22 patients 24 IC~1 severe stenosis and 4 ICA occlusion were found. Thev presented with 5 TI.~1's, 9 strokes and 2 completely asymptomatic. 19 had visual symptoms: 11 amaurosis fugax 3 decline in visual acuity, 3 both and 2 black spots. 13 patients (16 eyes) had decline in visual acuity objectively. The ocular background ischemic changes were present in 11 patients: neovascularisation on the disc in 3 patients (4 eyes), peripheral hemorrhage in 8 and cotton-wool patches in one patient. In the 28 affected eye there were 6 inversed 0~1 flow. Mean MF'V in affected eye with physiological flow direction, was 24.2&plusmn ; 16.09cm/s and in nonaffected eye 43.8&plusmn ; 17.45cm/s (p<0.05). Although some patients with advanced carotid stenosis or occlusion were ophthalmologicaly asymptomatic, ophthalmologic examination revealed ischemic changes. In all patients OA flow abnormality was found suggesting a background for ocular ischemic changes.

rethinopathy; carotid stenosis

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