Classification of Ophthalmic Artery Flow in Patients with Occlusive Carotid Artery Disease

Abstract

To investigate and classify the ophthalmic artery (OA) flow patterns in patients with occlusive carotid artery disease (OCAD). Forty-three patients (52 eyes) with documented OCAD of > or =70% underwent orbital color Doppler imaging. The eyes were first divided into four groups by peak systolic velocity in OA (PSV(OA)): group A, PSV(OA) < or = 0; group B, 0 < PSV(OA) < or = 10; group C, 10 < PSV(OA) < or = 40; and group D, PSV(OA) > 40 cm/s, then further classified by the shape of the OA flow wave. The groups were then compared with respect to the collateral pathway (Co-Path), severity of the OCAD, and systemic diseases. Eyes with unidirectional reverse flow (group A(1)) had a Co-Path from the ipsilateral external carotid artery and 70%-100% OCAD. Eyes with bidirectional reverse flow (group A(2)) had no Co-Path, 75% OCAD, and impending ischemic heart disease (IHD). Group B eyes had dome-shaped OA flow waves with no Co-Path and 99%-88% OCAD. Group C(1) eyes, with normal flow waves, had a Co-Path from the contralateral internal carotid artery and 100% OCAD. Group C(2) eyes, with triangular-shaped flow waves, had no Co-Path, 93%-70% OCAD, and IHD. Group D eyes had normal high flow waves with no Co-Path, 75% OCAD, and hypertension. The OA flow patterns were variously affected by collateral pathway, severity of OCAD, and systemic diseases.