Effects of Surgical Treatment on Ophthalmic Arterial Blood Flow in Patients with Carotid Artery Stenosis and Ischemic Eye Disease and an Evaluation of Its Efficacy
1 Department of Ophthalmology, First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen 518035, China 2 Department of Neurosurgery, First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen 518035, China
Abstract: Objective: To investigate the effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on ophthalmic arterial blood flow mechanics and to compare the therapeutic effects of these two different methods on ocular ischemic disease. CEA and CAS were performed in carotid artery stenosis patients with ocular ischemic disease by color doppler flow imaging (CDFI). Methods: In this prospective clinical study, data were collected from 19 patients between December 2017 and December 2018 in the Second People's Hospital of Shenzhen Nerve Vascular Surgery by color doppler ultrasound examination (CDFI) or digital subtraction angiography (DSA) in the diagnosis of carotid stenosis and surgical treatment of line revascularization (including the CEA and CAS). Testing included dynamic detection of carotid stenosis, plaques and internal jugular vein, ophthalmic artery, central retinal artery, and parameters of central retinal venous blood flow mechanics: Peak systolic velocity (PSV, cm/s), end-diastolic velocity (EDV, cm/s), resistance index (RI), RI=(PSV-EDV)/PSV. Data before and after surgery were analyzed using a paired t test . Results: At last, 16 cases underwent CEA surgery, and 3 cases underwent CAS surgery. Three months after carotid endarterectomy and carotid stent plasty, the systolic peak flow rate (PSV) and enddiastolic flow rate (EDV) of the ophthalmic artery were significantly increased (t=5.470, 5.098, P<0.001). RI significantly decreased (t=3.624, P=0.003). After CEA or CAS treatment, temporary amaurosis in all patients disappeared. There were 12 cases in CEA group and 2 cases in CAS group got effective treatment. Conclusions: Carotid endarterectomy and carotid stent plasty can effectively improve the ocular hemodynamic indexes of ischemic eye disease caused by carotid artery stenosis and alleviate the symptoms of ischemic eye disease to some extent.
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Ye Wang1,Jianming Wu2,Junling He1,Jiang Guo1,Baikang Ye1,Junmeng Zeng1,Wen Zhao1,Lu Liu1,Xiaoyan Dou1. Effects of Surgical Treatment on Ophthalmic Arterial Blood Flow in Patients with Carotid Artery Stenosis and Ischemic Eye Disease and an Evaluation of Its Efficacy. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(6): 451-456. DOI: 10.3760/cma.j.cn115909-20201215-00482
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