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Abstract
We report on a 70-year-old Japanese man with complaints of worsening left visual acuity who was diagnosed with ocular ischemic syndrome (OIS) associated with internal carotid artery (ICA) stenosis. A gonioscopy examination showed rubeosis iridis and elevated intraocular pressure (IOP) in the left eye (50 mmHg) at the baseline visit. The optic nerve head (ONH) and choroidal blood flow measured by laser speckle flowgraphy (LSFG) was impaired in the left eye compared with that in the right eye. Additionally, the blowout score (BOS), which indicates the variation of the mean blur rate (MBR) during systolic and diastolic periods, was decreased in the left eye. After treatment with an injection of bevacizumab and administration of Rho-associated kinase-inhibitor ripasudil eye drops, both ocular blood flow and BOS in each vascular bed gradually increased along with IOP reduction. The visual acuity also improved. The current case demonstrated increased blood flow and decreased fluctuation of blood flow in the ONH and choroid before and after the treatment in OIS with rubeosis iridis. The LSFG technique is useful to non-invasively assess the ocular circulation and pulse waveform in OIS.
Highlights
Ocular ischemic syndrome (OIS) is caused by chronic ocular hypoperfusion associated with stenosis of the internal carotid artery (ICA) or the common carotid artery [1]
ICA stenosis strongly affects both retinal and choroidal blood circulation. This is due to the fact that the central retinal artery and the short posterior ciliary artery comes from the ICA [2,3]
It is very important to evaluate ocular blood flow in eyes with OIS associated with ICA stenosis using the non-invasive method
Summary
Ocular ischemic syndrome (OIS) is caused by chronic ocular hypoperfusion associated with stenosis of the internal carotid artery (ICA) or the common carotid artery [1]. ICA stenosis strongly affects both retinal and choroidal blood circulation. This is due to the fact that the central retinal artery and the short posterior ciliary artery comes from the ICA [2,3]. It is very important to evaluate ocular blood flow in eyes with OIS associated with ICA stenosis using the non-invasive method. Laser speckle flowgraphy (LSFG-NAVI® , Softcare Co. Ltd., Fukuoka, Japan) is a non-invasive quantitative method; it is very useful for measuring the ONH [10,11], retinal [12,13], and choroidal. To the best of our knowledge, the time course of the optic nerve head, choroidal blood flow, and pulse waveform using LSFG in OIS with rubeosis iridis is yet to be investigated. We present a case of OIS associated with ICA stenosis after the treatment in which LSFG was used
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