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Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease.
Ophthalmology. 1997 Dec; 104(12):1994-2002.O

Abstract

OBJECTIVE

The purpose of the study was to evaluate the ophthalmologic findings and to analyze the retrobulbar hemodynamics of patients with severe (greater than 70% stenosis) occlusive carotid artery disease (OCAD) by means of color Doppler imaging (CDI).

DESIGN

A case-controlled study.

PARTICIPANTS

Fifty-six consecutive patients with severe OCAD and an age- and sex-matched control group consisting of 56 healthy patients without OCAD were studied.

INTERVENTION

All 112 patients underwent a complete ophthalmologic examination. Color Doppler imaging of both orbits was performed by one masked investigator.

MAIN OUTCOME MEASURES

Peak systolic velocity, end diastolic velocity, and the resistive index of the ophthalmic, central retinal, and temporal short posterior ciliary arteries were measured. The authors compared the hemodynamic parameters measured in patients with severe OCAD with those obtained in the control group. The hemodynamic parameters of patients with asymmetric OCAD (stenosis > 70% in one internal carotid artery and stenosis < 50% in the contralateral artery) were also compared. In an attempt to determine risk factors associated with the ocular ischemic syndrome (OIS), the authors compared patients with severe OCAD and OIS with patients with severe OCAD without OIS.

RESULTS

Peak systolic and end diastolic velocities in the ophthalmic, central retinal, and temporal short posterior ciliary arteries were significantly lower in patients with severe OCAD (P < 0.01). The mean resistive indices in the central retinal and temporal short posterior ciliary arteries were higher in the group with severe OCAD (P < 0.01). Similar results were obtained in the analysis of 25 patients with asymmetric carotid stenosis. Younger age (P = 0.012), severe bilateral OCAD (P = 0.01), high-grade carotid stenosis (P = 0.013), and reversed ophthalmic artery flow (P = 0.038) were significant risk factors for OIS.

CONCLUSIONS

Patients with severe OCAD show hemodynamic changes that suggest reduced retrobulbar blood flow. Patients with severe bilateral OCAD, high-grade carotid stenosis, and reversed ophthalmic artery flow may have a greater risk of developing OIS.

Authors+Show Affiliations

Department of Ophthalmology, University of São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9400757

Citation

Costa, V P., et al. "Clinical Findings and Hemodynamic Changes Associated With Severe Occlusive Carotid Artery Disease." Ophthalmology, vol. 104, no. 12, 1997, pp. 1994-2002.
Costa VP, Kuzniec S, Molnar LJ, et al. Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease. Ophthalmology. 1997;104(12):1994-2002.
Costa, V. P., Kuzniec, S., Molnar, L. J., Cerri, G. G., Puech-Leão, P., & Carvalho, C. A. (1997). Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease. Ophthalmology, 104(12), 1994-2002.
Costa VP, et al. Clinical Findings and Hemodynamic Changes Associated With Severe Occlusive Carotid Artery Disease. Ophthalmology. 1997;104(12):1994-2002. PubMed PMID: 9400757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical findings and hemodynamic changes associated with severe occlusive carotid artery disease. AU - Costa,V P, AU - Kuzniec,S, AU - Molnar,L J, AU - Cerri,G G, AU - Puech-Leão,P, AU - Carvalho,C A, PY - 1997/12/24/pubmed PY - 1997/12/24/medline PY - 1997/12/24/entrez SP - 1994 EP - 2002 JF - Ophthalmology JO - Ophthalmology VL - 104 IS - 12 N2 - OBJECTIVE: The purpose of the study was to evaluate the ophthalmologic findings and to analyze the retrobulbar hemodynamics of patients with severe (greater than 70% stenosis) occlusive carotid artery disease (OCAD) by means of color Doppler imaging (CDI). DESIGN: A case-controlled study. PARTICIPANTS: Fifty-six consecutive patients with severe OCAD and an age- and sex-matched control group consisting of 56 healthy patients without OCAD were studied. INTERVENTION: All 112 patients underwent a complete ophthalmologic examination. Color Doppler imaging of both orbits was performed by one masked investigator. MAIN OUTCOME MEASURES: Peak systolic velocity, end diastolic velocity, and the resistive index of the ophthalmic, central retinal, and temporal short posterior ciliary arteries were measured. The authors compared the hemodynamic parameters measured in patients with severe OCAD with those obtained in the control group. The hemodynamic parameters of patients with asymmetric OCAD (stenosis > 70% in one internal carotid artery and stenosis < 50% in the contralateral artery) were also compared. In an attempt to determine risk factors associated with the ocular ischemic syndrome (OIS), the authors compared patients with severe OCAD and OIS with patients with severe OCAD without OIS. RESULTS: Peak systolic and end diastolic velocities in the ophthalmic, central retinal, and temporal short posterior ciliary arteries were significantly lower in patients with severe OCAD (P < 0.01). The mean resistive indices in the central retinal and temporal short posterior ciliary arteries were higher in the group with severe OCAD (P < 0.01). Similar results were obtained in the analysis of 25 patients with asymmetric carotid stenosis. Younger age (P = 0.012), severe bilateral OCAD (P = 0.01), high-grade carotid stenosis (P = 0.013), and reversed ophthalmic artery flow (P = 0.038) were significant risk factors for OIS. CONCLUSIONS: Patients with severe OCAD show hemodynamic changes that suggest reduced retrobulbar blood flow. Patients with severe bilateral OCAD, high-grade carotid stenosis, and reversed ophthalmic artery flow may have a greater risk of developing OIS. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/9400757/Clinical_findings_and_hemodynamic_changes_associated_with_severe_occlusive_carotid_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(97)30066-9 DB - PRIME DP - Unbound Medicine ER -