Оценка влияния хирургической реконструкции внутренней сонной артерии на гемодинамику глаза и морфофункциональные показатели зрительного анализатора у пациентов с хронической ишемической нейрооптикопатией, ассоциированной с гемодинамически значимым атеросклеротическим стенозом внутренней сонной артерии

Abstract

Purpose. To evaluate the effect of carotid endarterectomy (CEA) on eye hemodynamics and morphofunctional parameters of the visual analyzer in patients with chronic ischemic neuropathy (CIN) associated with hemodynamically significant atherosclerotic stenosis of the internal carotid artery (ICA). Material and methods. The study included 50 patients (50 eyes) with unilateral manifestations of CIN. All patients underwent optical coherence tomography (OCT), Doppler ultrasound of the ophthalmic artery (OA), short posterior ciliary arteries (SPCA), central retinal artery (CRA) before and after surgical reconstruction of the ICA. Results. 24 months after CEA of the ICA, in all cases there were significant improvements in blood flow in the OA by 52.8 %, in the SPCA by 26 %, in the CRA by 30.2 %, a decrease in the thickness of the peripapillary layer of retinal nerve fibers by 9.5 % and the layer of ganglionic cells by 8 % relative to baseline (p < 0.05). Conclusion. The causes of CIN progression after ICA CEA can be considered as the consequences of induced reperfusion of the optic nerve structures and the brain. Keywords: chronic ischemic neuroopticopathy, ocular ischemic syndrome, internal carotid artery, carotid endarterectomy