Ocular ischemic appearance associated with carotid artery stenosis

Abstract

Objective To observe the clinical characteristics and therapeutic effects of carotid artery stenosis-related ocular ischemic appearance (OIA) . Methods The clinical data of 210 patients of carotid artery stenosis (81 of them with OIA) were retrospectively reviewed. They were diagnosed by color doppler image(CDI)or digital subtraction angiography (DSA), and had undergone medicine, carotid artery stenting (CAS)and carotid endarterectomy (CEA). Of 81 patients with OIA, 49 patients (60. 49%) with OIA only, 32 patients(39. 51%)with ocular ischemic disease (OID). 24/32 OID patients received ophthalmic treatment such as retinal laser photocoagulation and anti-glaucoma therapy (drugs and cyclocryotherapy). Results The ocular manifestations of 81 OIA patients included transient amaurosis in 38 cases (47. 14%), flash before the eye in 30 cases (36. 67%), periorbital swelling and pain in 28 cases (34. 57%), diplopia in 11 cases (13.58%) and vision loss in 9 cases (11. 11%). The ocular manifestations of 32 OID patients included ischemic optic neuropathy in 9 cases (28. 13%), ocular ischemic syndrome in 6 cases (18. 75%), central or branch retinal artery occlusion in 6 cases (18. 75%), retinal hemorrhage in 5 patients (15. 62%),extraocular muscle paralysis in 4 patients (12. 50%) and neovascular glaucoma in 2 patients (6. 25%). The higher the degree of carotid stenosis, the higher incidence of ocular ischemic disease, there was highly positive correlation between each other (R = 0. 837, P<0. 05). The total effective rate of carotid artery stenting and carotid endarterectomy was significantly higher than drug treatment alone (t = 2. 73, 3.14; P<0.01). Conclusion The ocular manifestations of carotid stenosis-related ocular ischemic appearance can be transient amaurosis, eyes flashing, eye redness, periorbital pain, diplopia and decreased visual acuity. The ocular manifestations of carotid stenosis-related ocular ischemic disease can be ischemic optic neuropathy, ocular ischemic symptoms, central or branch retinal artery occlusion and neovascular Carotid artery stenting and carotid endarterectomy are more effective than drug treatment alone for those patients. Key words: Carotid stenosis/diagnosis; Carotid stenosis/therapy; Carotid stenosis/complications; Optic neuropathy,ischemic/diagnosis; Optic neuropathy,ischemic/therapy