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Durusoy GK, Gumus G, Onay M, Altay CM, Binboga AB. EARLY COROIDAL STRUCTURE AND COROIDAL VASCULARITY INDEX CHANGE AFTER CAROTIS STENTING. Photodiagnosis Photodyn Ther 2022; 38:102748. [DOI: 10.1016/j.pdpdt.2022.102748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
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Zhou B, Ye P, Wei S. Preliminary clinical analysis of neovascular glaucoma secondary to carotid artery disease. Clin Exp Optom 2021; 94:207-11. [PMID: 21175823 DOI: 10.1111/j.1444-0938.2010.00555.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Biye Zhou
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Shihui Wei
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, China E‐mail:
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Turan-Vural E, Vural U. Evaluation of Peripapillary and Subfoveal Choroid Thickness in Asymptomatic Carotid Artery Stenosis. Clin Ophthalmol 2020; 14:1641-1650. [PMID: 32606579 PMCID: PMC7306471 DOI: 10.2147/opth.s237403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 06/03/2020] [Indexed: 11/23/2022] Open
Abstract
Objective In this study, it aims to investigate the effect of asymptomatic carotid artery stenosis on peripapillary and subfoveal choroid thickness using enhanced depth imaging optical coherence tomography. Patients and Methods While investigating for coronary artery disease, 76 patients with asymptomatic carotid artery stenosis and 35 patients with normal carotid artery (total = 111) were evaluated. Patients according to the degree of stenosis were divided into four categories as non-stenosis (n = 35), mild (n = 26), moderate (n = 27) and severe stenosis (n = 23). Subfoveal and peripapillary choroid thickness, ocular perfusion and intraocular pressures of all patients were measured using a Fourier-domain optical coherence tomography after general ophthalmological examination. In addition, hypertension, hyperlipidemia, and whether there is a relationship between smoking status and choroid thickness was compared. Results As the degree of carotid artery stenosis increased, subfoveal and peripapillary choroidal thickness decreased significantly. However, no changes were detected in ocular perfusion and intraocular pressure values (p=0.935, p=0.519). Decrease in peripapillary and subfoveal choroid thickness values was found to be particularly between the group with severe stenosis and the group with control and mild stenosis (p = 0.003, p = 0.001). In addition, as the degree of carotid stenosis increased in patients with hypertension and smoking, peripapillary choroid thickness was found to be thinner (p=0.003). Conclusion We believe that the possibility of carotid artery stenosis should be considered in cases with decreased choroid thickness. In addition, we think that even if it is asymptomatic, in cases with severe carotid stenosis, in the presence of choroidal thinning, a chance of surgical intervention should be given to the stenosis.
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Affiliation(s)
- Ece Turan-Vural
- Ophthalmology Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Unsal Vural
- Cardiovascular Surgery Clinic, Siyami Ersek Training and Research Hospital, Istanbul, Turkey
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Garcia-Martin E, Ruiz-de Gopegui E, León-Latre M, Otin S, Altemir I, Polo V, Larrosa JM, Cipres M, Casasnovas JA, Pablo LE. Influence of cardiovascular condition on retinal and retinal nerve fiber layer measurements. PLoS One 2017; 12:e0189929. [PMID: 29272287 PMCID: PMC5741228 DOI: 10.1371/journal.pone.0189929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess changes in the retinal nerve fiber layer (RNFL) and macula in subjects with cardiovascular risk factors or subclinical ischemia. DESIGN Prospective and observational study. METHODS A total of 152 healthy men underwent cardiovascular examination, including quantification of subclinical atheroma plaques by artery ultrasound scans, blood analysis, and a complete ophthalmic evaluation, including spectral-domain optical coherence tomography. The variables registered in cardiovascular examination were quantification of classic major risk factors, subclinical atheroma plaques by artery ultrasound scans, and analytical records. The ophthalmic evaluation registered RNFL and macular thickness. RESULTS Mean subject age was 51.27±3.71 years. The 40 subjects without classic cardiovascular risk factors did not show differences in RNFL and macular thicknesses compared with the 112 subjects with at least one risk factor (except in sector 9 that showed higher thicknesses in subjects with ≥1 risk factor). Comparison between the group of subjects with and without atheroma plaques revealed no differences in RNFL and macular thicknesses. The sub-analysis of subjects with subclinical atheroma plaques in the common carotid artery revealed a significant reduction in central macular thickness in the left eye compared with the right eye (p = 0.016), RNFL in the superior quadrant (p = 0.007), and the 11 o'clock sector (p = 0.020). Comparison between smokers and nonsmokers revealed that smokers had significant thinning of the central macular thickness (p = 0.034), the nasal RNFL quadrant (p = 0.006), and the 3 and 5 o'clock sectors (p = 0.016 and 0.009). CONCLUSIONS Classic cardiovascular risk factors do not cause RNFL or macular thickness reduction, but tobacco smoking habit reduces nasal RNFL thickness. Subclinical atherosclerosis in the common carotid artery associates a reduction in central macular and nasal RNFL quadrant thicknesses in the left eye compared with the right eye.
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Affiliation(s)
- Elena Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Erika Ruiz-de Gopegui
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Montserrat León-Latre
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
- Health Center La Jota, Aragon Health Service, Zaragoza, Spain
| | - Sofia Otin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Irene Altemir
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Vicente Polo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Jose M. Larrosa
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Marta Cipres
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
| | - Jose A. Casasnovas
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
- Department of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Luis E. Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IACS-IIS Aragon), Zaragoza, Spain
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Kim YH, Sung MS, Park SW. Clinical Features of Ocular Ischemic Syndrome and Risk Factors for Neovascular Glaucoma. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:343-350. [PMID: 28682017 PMCID: PMC5540990 DOI: 10.3341/kjo.2016.0067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/04/2016] [Indexed: 12/20/2022] Open
Abstract
Purpose We aimed to examine the clinical features and prognosis of ocular ischemic syndrome and to investigate the risk factors for the development of neovascular glaucoma (NVG). Methods The medical records from 25 patients (25 eyes) who were diagnosed with ocular ischemic syndrome were retrospectively analyzed. We recorded the length of time between symptom onset and diagnosis, visual acuity, intraocular pressure, clinical findings of the anterior and posterior segments of the eye, fluorescein angiography, systemic diseases, smoking history, and the extent of any ipsilateral carotid artery stenosis. The risk factors for NVG in patients with ocular ischemic syndrome were investigated. Results The mean age was 67.9 ± 12.5 years, and 21 men and 4 women were included in this study. At initial examination, the mean logarithm of the minimum angle of resolution (logMAR) was 2.02 ± 1.26, and the mean intraocular pressure was 21.0 ± 10.3 mmHg. Among 25 eyes of the 25 patients, NVG occurred in 17 eyes after a mean period of 12.6 ± 14.0 months. The length of time between symptom onset and diagnosis (p = 0.025) and the extent of ipsilateral carotid artery stenosis (p = 0.032) were identified as significant risk factors for NVG. At the final follow-up, the mean logMAR visual acuity was 3.13 ± 1.24, showing a poor prognosis regardless of whether NVG occurred. Conclusions Overall, the prognosis for ocular ischemic syndrome is very poor. The risk of NVG increases with the length of time between symptom onset and diagnosis, as well as with the severity of ipsilateral carotid artery stenosis.
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Affiliation(s)
- Yung Hui Kim
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Mi Sun Sung
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Woo Park
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
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Sayin N, Kara N, Uzun F, Akturk IF. A quantitative evaluation of the posterior segment of the eye using spectral-domain optical coherence tomography in carotid artery stenosis: a pilot study. Ophthalmic Surg Lasers Imaging Retina 2015; 46:180-5. [PMID: 25707042 DOI: 10.3928/23258160-20150213-20] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/16/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the posterior segment of the eye using spectral-domain optical coherence tomography (SD-OCT) in patients with internal carotid artery (ICA) stenosis. PATIENTS AND METHODS Prospective study enrolling 25 patients with ICA stenosis (study group) and 25 age- and gender-matched healthy individuals (control group). Macular choroidal thickness (CT) was measured at the fovea; other CT measurements were taken 1,000 µm away from the fovea in the nasal, temporal, superior, and inferior regions by enhanced-depth imaging OCT (EDI-OCT). The thicknesses of the retinal nerve fiber layer (RNFL), macula, and ganglion cell complex (GCC) were measured with SD-OCT. Correlations between the CT values and the degree of ICA stenosis were also evaluated. RESULTS Mean macular CT values in the study group were significantly thinner than those of the control groups for all quadrants (P < .05). There was no significant correlation between the degree of ICA stenosis and the CT values. Moreover, the mean thicknesses of the RNFL, macula, and GCC did not differ between the two groups. CONCLUSION The results suggest that CT decreases in patients with ICA stenosis compared with age-matched healthy individuals, whereas the RNFL, macular, and GCC thicknesses are comparable.
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Cohen R, Padilla J, Light D, Diller R. Carotid artery occlusive disease and ocular manifestations: Importance of identifying patients at risk. ACTA ACUST UNITED AC 2010; 81:359-63. [PMID: 20630374 DOI: 10.1016/j.optm.2009.10.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 09/12/2009] [Accepted: 10/23/2009] [Indexed: 12/20/2022]
Abstract
Ocular manifestations of carotid artery occlusive disease, when present, warrant further systemic workup including carotid artery Doppler ultrasound scan. Vascular ocular pathology that may indicate underlying carotid artery disease includes amaurosis fugax, retinal emboli, ocular ischemic syndrome, retinal vascular occlusions, and glaucoma. Early atherosclerotic changes, however, may remain undetected with carotid artery Doppler ultrasound scan. Risk factors for atherosclerosis should be assessed, and additional imaging to detect underlying pathophysiology of carotid artery occlusive disease may also be indicated for preventative management. A review of the literature is conducted to determine the association of ocular sequelae with hemodynamically significant carotid artery stenosis. The role of brachial artery flow-mediated dilation as an independent predictor for cardiovascular disease is also discussed.
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Affiliation(s)
- Raneat Cohen
- Dayton Veterans Affairs Medical Center, Dayton, OH, USA.
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Norris V, Bresson-Dumont H, Gardea E, Reusch RN, Gruber D. Hypothesis: Poly-(R)-3-hydroxybutyrate is a major factor in intraocular pressure. Med Hypotheses 2009; 73:398-401. [DOI: 10.1016/j.mehy.2008.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Revised: 04/12/2009] [Accepted: 10/15/2008] [Indexed: 01/27/2023]
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Pache M, Flammer J. A Sick Eye in a Sick Body? Systemic Findings in Patients with Primary Open-angle Glaucoma. Surv Ophthalmol 2006; 51:179-212. [PMID: 16644363 DOI: 10.1016/j.survophthal.2006.02.008] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite intense research, the pathogenesis of primary open-angle glaucoma (POAG) is still not completely understood. There is ample evidence for a pathophysiological role of elevated intraocular pressure; however, several systemic factors may influence onset and progression of the disease. Systemic peculiarities found in POAG include alterations of the cardiovascular system, autonomic nervous system, immune system, as well as endocrinological, psychological, and sleep disturbances. An association between POAG and other neurodegenerative diseases, such as Alzheimer disease and Parkinson disease, has also been described. Furthermore, the diagnosis of glaucoma can affect the patient's quality of life. By highlighting the systemic alterations found in POAG, this review attempts to bring glaucoma into a broader medical context.
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McCullough HK, Reinert CG, Hynan LS, Albiston CL, Inman MH, Boyd PI, Welborn MB, Clagett GP, Modrall JG. Ocular findings as predictors of carotid artery occlusive disease: is carotid imaging justified? J Vasc Surg 2004; 40:279-86. [PMID: 15297821 DOI: 10.1016/j.jvs.2004.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Hemispheric neurologic symptoms, amaurosis fugax, and Hollenhorst plaques at eye examination are standard indications for carotid imaging to identify carotid artery occlusive disease (CAOD). Previous reports have suggested that other ocular findings, such as retinal artery occlusion and anterior ischemic optic neuropathy, are associated with CAOD. However, the predictive value of ocular findings for the presence of CAOD is controversial. The purpose of this study was to define the predictive value of ocular symptoms and ophthalmologic examination in identifying significant CAOD. METHODS Over 3 years 145 patients were referred for carotid imaging on the basis of ocular indications in 160 eyes. Forty patients were excluded because of concurrent non-ocular indications for carotid imaging, leaving 105 patients referred exclusively for ocular indications to evaluate. Ophthalmologic history and eye examination were correlated with carotid duplex ultrasound findings. RESULTS Amaurosis fugax was associated with a positive scan in 20.0% of carotid arteries (P =.022). Hollenhorst plaques at fundoscopic examination were associated with a positive scan in 18.2% of carotid arteries (P =.02). Ocular findings exclusive of Hollenhorst plaques were particularly poor predictors of CAOD, inasmuch as only 1 of 64 arteries (1.6%) had significant ipsilateral internal carotid artery stenosis (P =.022). Venous stasis retinopathy was the only ocular finding other than Hollenhorst plaques with any predictive value (1 of 5 scans positive; positive predictive value, 20.0%). CONCLUSIONS Ocular symptoms and findings are poor predictors of CAOD. Amaurosis fugax, Hollenhorst plaques, and venous stasis retinopathy demonstrated moderate predictive value, whereas all other ocular findings demonstrated no predictive value in identifying CAOD.
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Affiliation(s)
- Heath K McCullough
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, 75390, USA
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Barkana Y, Harris A, Hefez L, Zaritski M, Chen D, Avni I. Unrecordable pulsatile ocular blood flow may signify severe stenosis of the ipsilateral internal carotid artery. Br J Ophthalmol 2004; 87:1478-80. [PMID: 14660457 PMCID: PMC1920575 DOI: 10.1136/bjo.87.12.1478] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To examine the relation between stenosis of the internal carotid artery (ICA) and pulsatile ocular blood flow (POBF). METHODS In 57 eyes of 30 patients who were referred for Doppler ultrasound examination of the ICA we measured POBF and analysed the correlation with degree of ipsilateral ICA stenosis. RESULTS There was a significant negative correlation between POBF and ipsilateral ICA stenosis (Pearson correlation coefficient, r=-0.516, p<0.0001). In 14 eyes POBF could not be measured by the OBF tonometer, and in 11 of these cases (79%) severe stenosis (>75%) of the ipsilateral ICA was present. When these eyes were excluded from analysis, there was no correlation between POBF and ICA stenosis (r=-0.02, p=0.91). Among these 43 eyes in which POBF could be measured it ranged 667-2095 microl/min with a mean of 970.72 microl/min. CONCLUSION Low or unrecordable POBF may signify severe stenosis of the internal carotid artery. POBF is not a direct reflection of ipsilateral ICA blood flow.
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Affiliation(s)
- Y Barkana
- Department of Ophthalmology, Assaf Harofe Medical Center, Beer Yaacov, Zerifin, Israel.
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Torre Leyva de la C, Nuez Galzagorri M. El daño arterial carotídeo en el paciente hipertenso. HIPERTENSION Y RIESGO VASCULAR 2004. [DOI: 10.1016/s1889-1837(04)71815-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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