engleski

Ischemic retinopathy in patients with advanced carotid stenosis

Background: Ophthalmic symptoms in patients with advanced carotid stenosis or occlusion are not always objectively evaluated. Aims: In order to examine the influence of internal carotid artery (ICA) advanced stenosis or occlusion on orbital flow, ophthalmic artery (OA) color Doppler flow imaging (CDFI) and ophthalmic examination were performed. Patients and methods: We investigated 22 consecutive patients with carotid advanced stenosis or occlusion, diagnosed by carotid and OA CDFI. History, neurological examination and ultrasound were obtained. OA were visualized, and angle corrected velocities were measured. Systolic, mean and diastolic blood flow velocities (BFV) were measured and flow direction was determined. Visual symptoms and ocular background Ischemic changes were evaluated. Data of neurological and ophthalmologic symptoms and findings are presented descriptively. Data of Doppler parameters of affected and non-affected eyes are presented as means and SD and compared by chi square test. Results: In 22 patients 24 ICA severe stenosis and 4 ICA occlusion were found. They presented with: 5 TIA&#8217; 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 haemorrhage in 8 and cotton-wool patches in one patient. In the 28 affected eyes there were 8 inversed OA flow. Mean systolic BFV in affected eye with physiological flow direction, was 24, 2+16, 09 cm/s and in non-affected eye 43, 8+17, 45 cm/s (p<0.05). Conclusion: Although some patients with advanced carotid stenosis or occlusion were ophthalmologic asymptomatic, ophthalmologic examination revealed ischemic changes. In all patients OA flow abnormality was found suggesting a background for ocular ischemic changes.

retinopathy; carotid stenosis; ultrasound

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