Reversal of ischemic retinopathy in ocular ischemic syndrome following carotid artery stenting

Abstract

PurposeOcular ischemic syndrome (OIS), also known as hypoperfusion retinopathy is a rare ocular disease determined by chronic arterial hypoperfusion. The risk factors include age between 50–80 years, male gender (M:F = 2:1), arterial hypertension, diabetes mellitus, coronary disease (5% of the cases develop ocular ischemic syndrome), vascular stroke, hemodialysis. The reported incidence is 7.5 cases per million persons every year and the five‐year mortality rate is 40%.MethodsInterventional case report showing the role of the early diagnosis and treatment with carotid artery stenting in a patient with OIS.ResultsA 58‐year‐old patient with primary arterial hypertension, hypercholesterolemia obstruction of right renal artery presented with multiple episodes of amaurosis fugax with a 5–10 min of duration since three months ago in right eye. Physical examination revealed uncorrected distant visual acuity of 20/20 in each eye. Fundus examination showed dilated retinal veins and multiples microhemorrhages in the right eye. Peripheral retinal ischemia was identified with fluorescein angiography. Doppler ultrasound examination revealed a more than 90% stenosis of the right internal carotid artery. Retinal signs of ischemia improved and amaurosis fugax episodes disappeared two months following internal carotid artery stentingConclusionsThe early diagnosis and treatment of patients with OIS have a major effect on their visual prognosis.