Perimetric and Retrobulbar Blood Flow Changes Following Carotid Endarterectomy

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2007 Apr 26

PMID 17457602

Citations 10

Authors

Vassilios P Kozobolis

Efstathios T Detorakis

George S Georgiadis

Athanassios A Achtaropoulos

Theofanis T Papas

Miltos K Lazarides

Affiliations

Soon will be listed here.

Abstract

Background: Carotid stenosis can produce visual changes. This study examines perimetric and retrobulbar blood flow changes following carotid endarterectomy (CEA) in patients without visual symptoms.

Methods: Sixteen patients (13 male, three female) with bilateral carotid stenosis were included. Patients with a history of ophthalmic disease, including glaucoma, were excluded. Peak systolic velocity (PSV) in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs) was measured preoperatively and 12 months following CEA with color Doppler imaging (CDI), using a 7.5 MHz probe, at both the side operated upon and its fellow side. Automated static perimetry (Octopus 500 perimeter, G1x program) was performed at the same intervals. Mean sensitivity (MS), mean defect (MD), loss variance (LV) and corrected loss variance (CLV) were recorded.

Results: Preoperative PSV in the OA was significantly lower in the side operated on. Preoperative perimetric parameters were significantly compromised, compared with normative data, in both eyes. Postoperatively, PSV had significantly improved in all vessels examined in the carotid that was operated on, but only in the OA and SPCAs in the fellow side. MD had significantly improved postoperatively for both eyes, whereas improvement in the other perimetric parameters examined was not statistically significant.

Conclusions: Perimetric changes occur in carotid stenosis. CEA results in the improvement of retrobulbar blood flow and perimetric parameters. Further research will be required to determine whether perimetric parameters may be used as additional indicators for carotid endarterectomy.

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References

Nemeth J, Kovacs R, Harkanyi Z, Knezy K, Senyi K, Marsovszky I . Observer experience improves reproducibility of color Doppler sonography of orbital blood vessels. J Clin Ultrasound. 2002; 30(6):332-5. DOI: 10.1002/jcu.10079. View

Matthiessen E, Zeitz O, Richard G, Klemm M . Reproducibility of blood flow velocity measurements using colour decoded Doppler imaging. Eye (Lond). 2004; 18(4):400-5. DOI: 10.1038/sj.eye.6700651. View

Schneider P, ROSSMAN M, Torem S, Otis S, Dillery R, Bernstein E . Transcranial Doppler in the management of extracranial cerebrovascular disease: implications in diagnosis and monitoring. J Vasc Surg. 1988; 7(2):223-31. DOI: 10.1067/mva.1988.avs0070223. View

Klijn C, Kappelle L, Tulleken C, van Gijn J . Symptomatic carotid artery occlusion. A reappraisal of hemodynamic factors. Stroke. 1997; 28(10):2084-93. DOI: 10.1161/01.str.28.10.2084. View

Gasser P, Flammer J, Guthauser U, Mahler F . Do vasospasms provoke ocular diseases?. Angiology. 1990; 41(3):213-20. DOI: 10.1177/000331979004100306. View

Vicent D, Ilany J, Kondo T, Naruse K, Fisher S, Kisanuki Y . The role of endothelial insulin signaling in the regulation of vascular tone and insulin resistance. J Clin Invest. 2003; 111(9):1373-80. PMC: 154437. DOI: 10.1172/JCI15211. View

Ho A, Lieb W, Flaharty P, Sergott R, Brown G, Bosley T . Color Doppler imaging of the ocular ischemic syndrome. Ophthalmology. 1992; 99(9):1453-62. DOI: 10.1016/s0161-6420(92)31784-1. View

Keunen R, Eikelboom B, Stegeman D, Ackerstaff R . Chronic cerebral hypotension induces a downward shift of the cerebral autoregulation: a hypothesis based on TCD and OPG-GEE studies in ambulatory patients with occlusive cerebrovascular disease. Neurol Res. 1994; 16(6):413-6. DOI: 10.1080/01616412.1994.11740265. View

Costa V, Kuzniec S, Molnar L, Cerri G, Puech-Leao P, Carvalho C . Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease. Ophthalmology. 1997; 104(12):1994-2002. DOI: 10.1016/s0161-6420(97)30066-9. View

10.

Kirshner R, Green R, Searl S, Deweese J . Ocular manifestations of carotid artery atheroma. J Vasc Surg. 1985; 2(6):850-3. View

11.

Quaranta L, Harris A, Donato F, Cassamali M, Semeraro F, Nascimbeni G . Color Doppler imaging of ophthalmic artery blood flow velocity: a study of repeatability and agreement. Ophthalmology. 1997; 104(4):653-8. DOI: 10.1016/s0161-6420(97)30256-5. View

12.

Schaser K, Settmacher U, Puhl G, Zhang L, Mittlmeier T, Stover J . Noninvasive analysis of conjunctival microcirculation during carotid artery surgery reveals microvascular evidence of collateral compensation and stenosis-dependent adaptation. J Vasc Surg. 2003; 37(4):789-97. DOI: 10.1067/mva.2003.139. View

13.

Barnett H, Taylor D, Eliasziw M, Fox A, Ferguson G, Haynes R . Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1998; 339(20):1415-25. DOI: 10.1056/NEJM199811123392002. View

14.

Costa V, Kuzniec S, Molnar L, Cerri G, Puech-Leao P, Carvalho C . The effects of carotid endarterectomy on the retrobulbar circulation of patients with severe occlusive carotid artery disease. An investigation by color Doppler imaging. Ophthalmology. 1999; 106(2):306-10. DOI: 10.1016/S0161-6420(99)90086-6. View

15.

Ward J, Hedges 3rd T, Heggerick P . Reversible abnormalities in the ophthalmic arteries detected by color Doppler imaging. Ophthalmology. 1995; 102(11):1606-10. DOI: 10.1016/s0161-6420(95)30821-4. View

16.

Costa V, Kuzniec S, Molnar L, Cerri G, Puech-Leao P, Carvalho C . Collateral blood supply through the ophthalmic artery: a steal phenomenon analyzed by color Doppler imaging. Ophthalmology. 1998; 105(4):689-93. DOI: 10.1016/S0161-6420(98)94025-8. View

17.

Fujioka S . Use of orbital color Doppler imaging for detecting internal carotid artery stenosis in patients with amaurosis fugax. Jpn J Ophthalmol. 2003; 47(3):276-80. DOI: 10.1016/s0021-5155(03)00016-9. View

18.

Osborne N, Block F, Sontag K . Reduction of ocular blood flow results in glial fibrillary acidic protein (GFAP) expression in rat retinal Müller cells. Vis Neurosci. 1991; 7(6):637-9. DOI: 10.1017/s0952523800010427. View

19.

Schmetterer L, Dallinger S, Findl O, Strenn K, Graselli U, Eichler H . Noninvasive investigations of the normal ocular circulation in humans. Invest Ophthalmol Vis Sci. 1998; 39(7):1210-20. View

20.

Rothwell P, Eliasziw M, Gutnikov S, Fox A, Taylor D, Mayberg M . Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet. 2003; 361(9352):107-16. DOI: 10.1016/s0140-6736(03)12228-3. View