Clinical characteristics of ocular ischemic syndrome

Abstract

To study clinical characteristics of ocular ischemic syndrome (OIS). Retrospective study. Data, including sex, age, systemic diseases, best corrected visual acuity, anterior segment, fundus, fundus fluorescence angiography (FFA), transcranial Doppler (TCD) and digital subtraction angiography (DSA), were collected from 10 patients (12 eyes) with ocular ischemic syndrome from February 2008 to April 2009. The mean age was 59 years. There were six males and four females. All patients were combined with heart and/or cerebrovascular diseases. Best corrected visual acuity ranged from hand movement to 1.0. Neovascularization of the iris appeared in 5 eyes. Intraocular pressure over 21 mm Hg (1 mm Hg = 0.133 kPa) was present in 3 eyes. Fundus examination showed narrow retinal arteries, dilated but not tortuous veins, fleck-shaped hemorrhage of the retina, cotton-wool exudates, optic disc edema, optic disc neovascularization, and atypical macular cherry-red spots. TCD showed stenosis of internal carotid artery at different degrees. FFA was performed in 9 patients which showed artery front, prolonged arm-retinal circulation time, retinal circulation time and choroid circulation time. All patients accepted vasodilation and microcirculation improving treatments. Visual acuity was improved at different degrees. One patient (2 eyes) with iris neovascularization was treated with retinal photocoagulation and the neovascularization disappeared after the treatment. There were 3 patients (3 eyes) had neovascular glaucoma. One patient was treated by ciliary cryotherapy. One patient was treated by retinal photocoagulation and internal carotid artery stent implantation and one were treated by internal carotid artery stent implantation. Four patients were examined by DSA. Internal carotid artery stent implantation was performed in 3 patients, subclavian artery stent implantation was performed in one patient and internal carotid artery intima decollement was performed in one patient. Clinical manifestations of ocular ischemic syndrome patients are complicated which are depended on the different extents of ischemia. The management of ocular ischemic syndrome requires the collaboration of ophthalmologists, neurophysicians and neurosurgeons.