Retinal vessels before and after carotid endarterectomy

Abstract

AbstractPurposeTo elucidate short term changes in retinal circulation following carotid endarterectomy (CEA).DesignProspective, non‐randomized, cohort study.Subjects and controlsNine patients were examined before and 5 weeks after CEA. Control group of nine medically healthy subjects was examined at baseline.MethodsAnalysis of clinical ocular findings and aspects of retinal and choroidal circulation included best‐corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment biomicroscopy, fundus photography and dynamic vessel analyzer (DVA) measurements. Central retinal arterial equivalent (CRAE), central retinal vein equivalent (CRVE) and arteriovenous ratio (AVR) were determined from 30° disc centered photographs using semi‐automated software, Vesselmap.Main outcome measuresRetinal circulation as expressed in CRAE, CRVE, AVR and DVA measurements.ResultsPreoperative ipsilateral CRVE was higher when compared to controls and to contralateral eyes: 235.8 μm (199.2–284.7) versus 205.9 μm (149.2–245.9) and versus 222.4 μm (200.7–259.4), p = 0.014 and p = 0.028, respectively. DVA flicker light‐induced venular vasodilatation increased postoperatively in ipsilateral eyes; 2.3% (0.3‐4.1) versus 2.6% (0.7‐5.1); p = 0.028. SFCT and IOP in ipsilateral eyes were comparable to contralateral eyes and controls preoperatively, and remained unchanged postoperatively.ConclusionsAfter CEA, retinal venules in ipsilateral eye appear less dilated indicating normalization in retinal circulation. Furthermore, flicker light‐induced vasodilatation increase, suggesting improved retinal endothelial function postoperatively.