Carotid arteries are the main blood vessels supplying the brain, neck, and face as well as ophthalmic arteries. Internal carotid arteriosclerosis is strictly associated with ophthalmic symptoms caused by damage to the optic nerve. This condition can manifest as an ocular ischemic syndrome or anterior ischemic optic neuropathy. One of the surgical procedures that treat carotid arteriosclerosis is an endarterectomy. It has been proved that this surgical procedure can additionally reduce intraocular pressure and improve visual acuity, best corrected visual acuity (BCVA), visual field, a bioelectrical function of the optic nerve and retina, and perfusion of the optic nerve head. It has been also observed that the procedure does not affect retinal nerve fiber layer thickness and ganglion cell layer. The aim of this review was, to sum up information on the influence of endarterectomy on the function of the optic nerve based on the up-to-date internet database.
Introduction Carotid arthrosclerosis can be a cause of visual impairment. It has been observed that carotid endarterectomy has a positive effect on ophthalmic parameters. The aim of this study was to evaluate the impact of endarterectomy on the optic nerve function. Materials and methods 54 asymptomatic patients (19 women and 35 men - 108 eyes) with unilateral carotid stenosis >70% of internal carotid artery, were recruited to the study. All of them were qualified for the endarterectomy procedure. The whole study group underwent Doppler ultrasonography of internal carotid arteries and ophthalmic examination before the surgery, with 22 of them (11 women and 11 men) were examined after the endarterectomy. The ophthalmic examination included; distant best-corrected visual acuity, measurement of the intraocular pressure, electrophysiology (pattern visual evoked potentials), perimetry, and optical coherent tomography (the retinal nerve fiber layer thickness). Discussion Carotid arteries supply brain and face with blood. Extensive research has observed a concomitant improvement in eyesight after enduring carotid endarterectomy in patients with artery stenosis. This effect was associated with a better blood flow in the ophthalmic artery and its branches, the central retinal artery and the ciliary artery; the major blood supply of the eye. Results The present study proved that carotid endarterectomy has a positive impact on the function of the optic nerve. The visual field parameters and amplitude of pattern visual evoked potentials significantly improved. Preoperative and postoperative values of intraocular pressure and the retinal nerve fiber layer thickness remained stable.
Carotid arteriosclerosis is the main cause of the stroke but it can also lead to ophthalmic symptoms. In this article, we aim to present four patients. All of them had hemodynamically significant but asymptomatic unilateral carotid stenosis and underwent internal carotid endarterectomy. Postoperatively, their visual function improved. Mean deviation in perimetry and values of amplitudes in pattern visual evoked potentials increased. Two patients improved visual acuity; in the other two, it remained stable.
Background. Carotid artery stenosis is often considered a stable clinical condition, and the underlying atherosclerosis is thought to have an inflammatory background.Objectives. The aim of the study was to assess the value of different parameters obtained from whole blood counts for the prediction of advanced carotid artery atherosclerosis, including vessel occlusion, irrespective of symptom occurrence. Materials and methods.The study group comprised 290 patients (84 (29%) females and 206 (71%) males) with a mean age of 68 ±8 years, who were admitted to the Vascular Surgery Department due to significant carotid artery disease. Patients were retrospectively divided into 2 subgroups regarding the presence or absence of artery occlusion. The demographic, clinical and laboratory preoperative data were compared between both groups.Results. We found significant differences in preoperative large unstained cell (LUC) counts between patients with and without carotid artery occlusion (p = 0.003), when analyzed with the Mann-Whitney test for independent samples. The receiver operating characteristic (ROC) curve showed that LUC count has prognostic properties for carotid artery occlusion, with an area under the curve (AUC) of 0.637 (p = 0.033), yielding a 69.70% sensitivity and a 51.75% specificity. Conclusions.Large unstained cells represent an acute inflammatory state related to artery occlusion. An LUC count below the cutoff value of 0. 16×10 9 /L may be a predictor of carotid artery occlusion. Therefore, carotid artery occlusion should not be regarded as a chronic state, but as a clinical challenge being promoted by active inflammatory processes.
We present a case report of a 46-year-old immunocompetent male, in whom the first clinical symptom of syphilis was binocular visual deterioration. Due to prompt diagnosis and casual treatment reconstitution of vision occurred within four weeks.
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