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The clinic analysis of ocular manifestations correlated to carotid artery stenosis .
作者:Tang Wei…  文章来源:Department of Ophthalmology, the General Hospital of Chinese PLA, Beijing 100853, China.  点击数1724  更新时间:2008/3/11 18:48:22  文章录入:毛进  责任编辑:毛进
OBJECTIVE: To probe the clinic characteristics, diagnoses and mechanisms of ocular manifestations correlated to carotid artery stenosis. METHODS: A retrospective analysis was performed on 124 patients who had carotid artery stenosis,the general clinic datas and ocular findings were reviewed. RESULTS: Of 124 patients, 36 (29%) patients had accompanied by ocular manifestations , and also 28 patients(22. 6%) represented the first symptoms of carotid artery stenosis; Among the 36 patients, 31 patients(86.1%) had been disclosed unilateral or double stenosis of internal carotid artery by carotid Doppler ultrasound examination, and digital subtract angiography found that 8 patients had the middle degree of internal carotid artery stenosis, and 23 patients had severe stenosis, however, the risk of developing ocular manifestations on the group of 67 cases of severe internal carotid artery stenosis did not exceed that of 34 cases of middle group; All positive eye findings included amaurosis fugax(52.8%), decline or loss of the visual ability and lesions of visual fields (36.1%), diplopia(13.9%), ptosis(13.9%),persistent high intraocular pressure(2.8%), and one patient could simultaneously accompanied by several ocular manifestations; 4 of central retinal artery occlusion(CRAO), 6 of central or branch retinal vein occlusion(CRVO or BRVO), 1 of neovascular glaucoma, and 2 of anterior ischemic optic-neuropathy had been diagnosed among 36 patients; The early stage of venous stasis retinopathy (VSR) may represent completely asymptomatic, 1 case of double occlusion of internal carotid artery had not accompanied by any ocular manifestation. CONCLUSIONS: Carotid artery stenosis, especially internal carotid artery may lead to acute or chronic ocular ischaemic lesions, the occurrence of ocular symptoms is related to compensatory circulation and retinal ischaemic time during the chronic course. Patients with ocular ischemic lesions are recommend to a routine carotid artery detection, regardless of whether they have had ocular symptoms.
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