Rapid Resolution of Venous Stasis Retinopathy After Carotid Endarterectomy

Neupert, Jerrol R.; Brubaker, Richard F.; Kearns, Thomas P.; Sundt, Thoralf M.

doi:10.1016/0002-9394(76)90123-9

Cited by 59 publications

(17 citation statements)

References 3 publications

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“…We have insufficient data to comment upon whether endarterectomy alone will cause regression of rubeosis iridis and reverse the other clinical signs, although removing the insulting lesion has previously been demonstrated to do so [7]. In regard to panretinal photocoagulation, we saw regression of iris neovascularization that we attributed to laser therapy in 36% of eyes.…”

Section: Discussionmentioning

confidence: 80%

“…Among the seven eyes in which the rubeosis iridis regressed (Cases los, 13, 19, 26, 28, 39, and 40 od, Table 4), five had undergone panretinal photocoagulation, one was treated with cyclocryotherapy, one had a combination of panretinal photocoagulation and cyclocryotherapy, four underwent STA-MCA bypass and two had endarterectomy. Concerning panretinal photocoagulation, among 14 eyes seen initially with rubeosis iridis that underwent PRP without cryotherapy and no endarterectomy or unsuccessful endarterectomy (100% occluded carotid) ( Table 4, cases, 7,9,11,13,19,21,24,26,27,31,34,39,40,44), the rubeosis regressed in 5 (36%). In one eye (case 26) the iris neovascularization disappeared following PRP alone.…”

Section: Resultsmentioning

confidence: 99%

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The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment

1991

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The records of fifty-two consecutive patients with the ocular ischemic syndrome seen between 1978 and 1985 were reviewed with the purpose of investigating the visual prognosis and effects of treatment. On initial presentation, 43% of affected eyes had a visual acuity of 20/20-20/50, whereas 37% were counting fingers or worse. By the end of one year, only 24% remained in the 20/20-20/50 group, while 58% were counting fingers or worse. The presence of rubeosis iridis was an indicator of poor visual prognosis. Ninety-seven percent of eyes with rubeosis had vision of counting fingers or worse at the end of one year. We were unable to demonstrate convincingly that carotid endarterectomy and superficial temporal artery to middle cerebral artery bypass were of benefit in stabilizing or improving vision in persons with the ocular ischemic syndrome.

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Section: Discussionmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment

1991

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“…In order to diagnose hemodynamically determined ophthalmological syndromes in carotid stenoses as well as for the assessment of the effect of carotid artery desobstruction and extra-intracranial (EC-IC) arterial bypass surgery on the vascular state of the eye, measurement of the ophthalmic blood pressure is either recommended or executed [3,29,30,31].…”

Section: Discussionmentioning

confidence: 99%

OODG-Ulrich and OPG-Gee: a comparative study

Strik¹

1988

Doc Ophthalmol

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For an adequate assessment of both the ophthalmological and the neurological consequences of carotid obstruction measurement of the blood pressure in the carotid flow area is essential. To this end there are two objective, registrating methods available at the moment: OPG-Gee and OODG-Ulrich. A comparative study was made into the basic principles, calibration curves and application methods of these systems. By both methods the systolic retinal--and ciliary--as well as the diastolic ocular blood pressure can be measured. OODG is more exact for the differentiation and measurement of the two systolic blood pressures. OPG-Gee, however, offers the unique additional possibility of a judgement on the systolic blood pressure in the carotid siphon without, however, taking into account a (difference in) pre-existing intraocular pressure. Our own investigation shows that in order to obtain a correct assessment of the carotico-brachial relation both blood pressures should be measured simultaneously. The results of the graphic analysis of the curves are compared to those by Ulrich. For the diagnosis of carotid obstructions this analysis of the shape had no advantages over the determination of the pressure values. Finally, a survey is given of possible applications of OPG and OODG in various other syndromes.

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“…A report by Neupert and others documented photographically the rapid resolution of venousstasis retinopathy in 1 case after internal carotid endarterectomy. 8 In our 4 cases treated by endarterectomy of the ipsilateral ICA (Group C), fluorescein angiography provided evidence of improvement in retinal ischemia as early as 1 month after surgery. In all cases microaneurysms were fewer after surgery, and in 2 cases arteriovenous transit time was reduced.…”

Section: Discussionmentioning

confidence: 99%

Assessment by fluorescein angiography of surgical treatment of occlusive carotid artery disease.

Sarkies¹,

Shilling²,

Burnand³

et al. 1987

Stroke

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Fundus fluorescein angiography was performed in 10 cases of occlusive carotid artery disease at presentation and after surgery or medical treatment. An improvement in the mlcrocirculation of the retina was observed in 4 cases after carotid endarterectomy and in 1 case after carotid endarterectomy and extracraniaMntracranial bypass. Improvement was not observed in 2 cases after extracranialintracranial bypass alone or in 3 cases in which surgical intervention was not undertaken. Our results suggest that carotid endarterectomy is a more effective procedure than extracranial-intracranial bypass in improving retinal perfusion when compromised by ipsilateral carotid obstruction. (Stroke 1987; 18:585-590) O cclusive disease of the carotid artery may produce ocular signs of retinal emboli, 1 chronic ocular ischemia, 2 neovascular glaucoma, 3 or venous-stasis retinopathy. 45 This latter term was used by Kearns and Hollenhorst for the combination of dilated veins, blossom-shaped hemorrhages, microaneurysms, and sludging of blood in the veins. Venousstasis retinopamy has been found in 12% of patients with unilateral carotid occlusion and 17% of patients with bilateral carotid occlusion. 6Fluorescein angiography is more sensitive than ophthalmoscopy in detecting minor microvascular abnormalities in the retina. Performing fluorescein angiography in patients with carotid occlusion or stenosis, we found abnormalities in 67% of cases. 7Fluorescein angiography may also be used in this group to assess whether carotid surgery improves retinal ischemia. This report reviews the findings of fluorescein angiography at diagnosis and follow-up in 10 patients with carotid occlusion or stenosis. Five patients had carotid artery surgery, 2 patients had extracranial-intracranial (EC-IC) anastomosis alone, and 3 patients had medical treatment only. Subjects and MethodsThese 10 cases may be considered in 4 groups depending on their management (Table 1). Two patients had superficial temporal-to-middle cerebral artery (ST-MCA) anastomosis alone (Group A), 1 patient had an external and internal carotid endarterectomy as well as a ST-MCA anastomosis (Group B), 4 patients had internal carotid endarterectomies (Group C), and 3 patients had medical treatment only (Group D).

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Rapid Resolution of Venous Stasis Retinopathy After Carotid Endarterectomy

Cited by 59 publications

References 3 publications

The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment

The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment

OODG-Ulrich and OPG-Gee: a comparative study

Assessment by fluorescein angiography of surgical treatment of occlusive carotid artery disease.

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