Ocular ischemic appearance associated with carotid artery stenosis and its influence factor_Chinese Journal of Ocular Fundus Diseases

Authors：

 HuangMinhui , GaoZhonghai , LinLiexing , 李力 , 李青

Physical Examination Department, Fujian Provincial Hospital, Fuzhou 350001, China;

Corresponding author：

HuangMinhui, Email: huangminhui2009@hotmail.com

Keywords：

Carotid stenosis/complications; Optic neuropathy,ischemic/diagnosis

DOI：

10.3760/cma.j.issn.1005-1015.2014.05.011

Video：

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Objective To observe the prevalence of ocular ischemic appearance (OIA) associated with carotid artery stenosis, and to explore the correlation between the ocular ischemic appearance and the carotid stenosis degree and location. Methods A total of 132 patients with carotid artery stenosis diagnosed by color Doppler ultrasound and CT angiography were enrolled in this prospective study. The carotid stenosis degree and location were identified. The ophthalmic symptoms was inquired. The corrected vision, diopter, intraocular pressure, slit lamp microscope and fundus examination were used to determine if OIA exists. The correlation between the OIA and the carotid stenosis degree and location were analyzed. The carotid stenosis degree was divided into 4 types: mild (≤50%), moderate (<50% but ≤75%), severe (<75% but ≤99%) and occlusion (100%). Results The distribution of carotid stenosis degree as follow: mild in 16 patients (12.1%), moderate in 46 patients (34.8%), severe in 50 patients (37.9%) and occlusion in 20 patients (15.2%). The stenosis located in the external carotid artery in 21 patients (15.9%), in internal carotid artery in 46 patients (34.8%), in crotch of extracranial internal carotid artery in 55 patients (41.7%), and in common carotid artery in 10 patients (7.6%). There were 54 patients (40.9%) with ocular ischemic diseases, which including retinal arterial obstruction (5 patients, 9.2%), retina change of venous stasis (13 patients, 24.1%), neovascular glaucoma (7 patients, 13.0%), ischemic optic neuropathy (19 patients, 35.2%), ocular ischemia syndrome (10 patients, 18.5%). The ophthalmic symptoms included transient amaurosis, decreased visual acuity, eye and periorbital pain, retinal hemorrhage and exudation, diplopia, rubeosis iridis and increased intraocular pressure. There was highly positive correlation between the carotid stenosis degree and OIA (r=0.287, P=0.018). There was no correlation between the carotid stenosis location and OIA (P>0.05). Conclusion 40.9% carotid stenosis patients has OIA. There is relationship between the carotid stenosis degree and OIA, but carotid stenosis location showed no correlation with OIA.

Citation： HuangMinhui, GaoZhonghai, LinLiexing. Ocular ischemic appearance associated with carotid artery stenosis and its influence factor. Chinese Journal of Ocular Fundus Diseases, 2014, 30(5): 473-476. doi: 10.3760/cma.j.issn.1005-1015.2014.05.011 Copy

1.	唐维强,魏世辉. 颈动脉狭窄与眼部缺血性病变[J]. 吉林大学学报(医学版), 2007, 33:191-193.
2.	赵军,胡莲娜,魏世辉. 眼缺血性疾病对预测颈动脉狭窄发生的意义[J]. 国际眼科杂志, 2009, 9:361-362.
3.	Ishikawa K, Kimura I, Shinoda K, et al. In situ confirmation of retinal blood flow improv ement after carotid endarterectomy in a patient with ocular is chemic syndrome[J]. Am J Ophthalmol, 2002, 134:295-297.
4.	王锡明, 武乐斌, 邵广瑞, 等. 多层螺旋CT成像技术在全身血管造影中的应用[J]. 中国医学影像技术, 2002,18:333-334.
5.	凌锋,缭中荣. 缺血性脑血管病血管内治疗前影像学评价[M]//凌锋,缭中荣. 缺血性脑血管病介入治疗学. 南京:江苏科学技术出版社,2003:39-40.
6.	赵军,魏世辉. 颈动脉狭窄致眼缺血性疾病初探[J].中国实用眼科杂志, 2006, 24:521-523.
7.	Lyons Wait VA, Anderson SF, Towns end JC, et al. Ocular and systemic finding sand their correlation with hemodynamically significant carotid artery stenosis:a retrospective study[J]. Optom Vis Sci, 2002, 79:353-362.
8.	马廉亭,潘力. 脑血管造影仍是诊断脑血管病的金标准[J]. 中国现代神经疾病杂志, 2007, 7:413-415.
9.	崔立明, 韩萍, 周阳泱, 等. 主动脉瘤多层螺旋CT血管成像的临床应用价值[J]. 临床放射学杂志, 2005, 24:691-694.
10.	Mark JW, Koelemay PJ, Nederkoorn JB, et al.Systematicreview of computed tomographicangiography for assessment ofcarotid artery disease[J].Stroke, 2004, 35:2306-2312.
11.	Nederkoorn PJ, van der Graaf Y, Hunink MG, et al. Duplex ultrasound and magnetic resonance angiography compared with digital subtraction angiography in carotid artery stenosis:a systematic review[J]. Stroke, 2003, 34:1324-1331.
12.	Klijn CJ, Kappelle LJ, van Schooneveld MJ, et al. Venous stasis retinopathy in symptomatic carotid artery occlusion:prevalence, cause, and outcome[J]. Stroke, 2002, 33:695-701.
13.	Lawrence PF, Oderich GS. Ophthalmologic findings as predictors of carotid artery disease[J]. Vasc Endovascular Surg, 2002, 36:415-424.
14.	Mendrinos E, Machinie TG, Pournaras CJ. Ocular ischemic syndrome[J]. Surv Ophthalmol, 2010, 55:2-34.
15.	Hashimoto M, Ohtsuka K, Ohtsuka H, et al. Normal-tension glaucoma with reversed ophthalmic artery flow[J]. Am J Ophthalmol, 2000, 130:670-672.
16.	Costa VP, Kezniec S, Molnar LJ, et al. Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease[J]. Ophthalmology, 104:1994-2002.

1. 唐维强,魏世辉. 颈动脉狭窄与眼部缺血性病变[J]. 吉林大学学报(医学版), 2007, 33:191-193.
2. 赵军,胡莲娜,魏世辉. 眼缺血性疾病对预测颈动脉狭窄发生的意义[J]. 国际眼科杂志, 2009, 9:361-362.
3. Ishikawa K, Kimura I, Shinoda K, et al. In situ confirmation of retinal blood flow improv ement after carotid endarterectomy in a patient with ocular is chemic syndrome[J]. Am J Ophthalmol, 2002, 134:295-297.
4. 王锡明, 武乐斌, 邵广瑞, 等. 多层螺旋CT成像技术在全身血管造影中的应用[J]. 中国医学影像技术, 2002,18:333-334.
5. 凌锋,缭中荣. 缺血性脑血管病血管内治疗前影像学评价[M]//凌锋,缭中荣. 缺血性脑血管病介入治疗学. 南京:江苏科学技术出版社,2003:39-40.
6. 赵军,魏世辉. 颈动脉狭窄致眼缺血性疾病初探[J].中国实用眼科杂志, 2006, 24:521-523.
7. Lyons Wait VA, Anderson SF, Towns end JC, et al. Ocular and systemic finding sand their correlation with hemodynamically significant carotid artery stenosis:a retrospective study[J]. Optom Vis Sci, 2002, 79:353-362.
8. 马廉亭,潘力. 脑血管造影仍是诊断脑血管病的金标准[J]. 中国现代神经疾病杂志, 2007, 7:413-415.
9. 崔立明, 韩萍, 周阳泱, 等. 主动脉瘤多层螺旋CT血管成像的临床应用价值[J]. 临床放射学杂志, 2005, 24:691-694.
10. Mark JW, Koelemay PJ, Nederkoorn JB, et al.Systematicreview of computed tomographicangiography for assessment ofcarotid artery disease[J].Stroke, 2004, 35:2306-2312.
11. Nederkoorn PJ, van der Graaf Y, Hunink MG, et al. Duplex ultrasound and magnetic resonance angiography compared with digital subtraction angiography in carotid artery stenosis:a systematic review[J]. Stroke, 2003, 34:1324-1331.
12. Klijn CJ, Kappelle LJ, van Schooneveld MJ, et al. Venous stasis retinopathy in symptomatic carotid artery occlusion:prevalence, cause, and outcome[J]. Stroke, 2002, 33:695-701.
13. Lawrence PF, Oderich GS. Ophthalmologic findings as predictors of carotid artery disease[J]. Vasc Endovascular Surg, 2002, 36:415-424.
14. Mendrinos E, Machinie TG, Pournaras CJ. Ocular ischemic syndrome[J]. Surv Ophthalmol, 2010, 55:2-34.
15. Hashimoto M, Ohtsuka K, Ohtsuka H, et al. Normal-tension glaucoma with reversed ophthalmic artery flow[J]. Am J Ophthalmol, 2000, 130:670-672.
16. Costa VP, Kezniec S, Molnar LJ, et al. Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease[J]. Ophthalmology, 104:1994-2002.

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