The effects of carotid artery stenting on ophthalmic artery blood flow in ischemic ophthalmopathy patients_Chinese Journal of Ocular Fundus Diseases

Authors：

LI Xiaochun ,  Gao Ying , Bao Xiang , Jiang Fengfeng , Luo Danyue

Department of Ophthalmology (LI Xiaochun, Gao Ying), Department of Neurosurgery (Bao Xiang, Jiang Fengfeng), Ultrasonic Department (Luo Danyue), Jinhua Hospital of Zhejiang University, Jinhua 321000, China;

Corresponding author：

Gao Ying, Email: gaoy59@126.com

Keywords：

Carotid artery stenting; Arotid artery stenosis; Ocular ischemic disease; Color doppler flow imaging; Hemodynamics

DOI：

10.3760/cma.j.issn.1005-1015.2018.03.012

Video：

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ObjectiveTo observe the effects of carotid artery stenting (CAS) on ophthalmic artery blood flow in patients with ischemic ophthalmopathy (IOP).MethodsA prospective case-control study. Sixty IOP patients (60 eyes) who met inclusive criteria for CAS were enrolled in this study. There was 50% stenosis of internal carotid artery on one side at least confirmed by color doppler flow imaging (CDFI). Among 60 eyes, there were 3 eyes with central retinal artery occlusion, 15 eyes with retinal vein occlusion, 37 eyes with ischemic optic neuropathy, 5 eyes with ocular ischemia syndrome. The patients were randomly divided into CAS group (32 eyes of 32 patients) and medicine therapy group (28 eyes of 28 patients). The difference of age (t=1.804) and sex (χ²=1.975) between two groups was not significant (P＞0.05). The examinations of fundus fluorescein angiography (FFA), CDFI and digital substraction angiography (DSA) were performed before, 1 week and 6 months after treatment. The following parameters were recorded: arm-retinal circulation time (A-Rct), peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) in the ophthalmic artery (OA) and central retinal artery (CRA), and the best corrected visual acuity (BCVA).ResultsThere was no significant differences in A-Rct (t=1.354) and BCVA (t=0.376) between the two groups before treatment (P＞0.05). Also, there was no significant differences in PSV (t=−0.294, −2.446), EDV (t=0.141, −0.305), and RI (t=−0.222, −0.694) of OA and CRA between the two groups before treatment before treatment (P＞0.05). Compared with the medicine therapy group, the lower A-Rct was found in the CAS group at different time points after the treatment. The difference was significant on 1 week after treatment (t=−3.205, P＜0.05), but not on 6 months after treatment (t=1.345, P＞0.05). The BCVA of eyes in the two groups were increasing with the extending of time of therapy. Compared with the medicine therapy group, the better BCVA was found in the CAS group at different time points after the treatment (t=0.800, 1.527; P＜0.05). Compared with the medicine therapy group, the higher PSV, EDV and lower RI of OA and CRA were found in the CAS group at different time points after the treatment. (P＜0.05).ConclusionCompared with conventional medicine therapy, CAS shows earlier effects in improving ocular hemodynamics for IOP patients with carotid artery stenosis, which benefits visual function improvement of the patients.

Citation： LI Xiaochun, Gao Ying, Bao Xiang, Jiang Fengfeng, Luo Danyue. The effects of carotid artery stenting on ophthalmic artery blood flow in ischemic ophthalmopathy patients. Chinese Journal of Ocular Fundus Diseases, 2018, 34(3): 258-262. doi: 10.3760/cma.j.issn.1005-1015.2018.03.012 Copy

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8.	Terelak-Borys B, Skonieczna K, Grabska-Liberek I.Ocular ischemic syndrome - a systematic review[J]. Med Sci Monit, 2012, 18(8): 138-144.
9.	Kiseleva TN, Tarasova LN, Fokin AA, et al. Follow-up results of surgical correction of ocular ischemic syndrome[J]. Vestn Oftalmol, 2003, 119(4): 22-24.
10.	Esteban O, Nuñez E, Ascaso J, et al. Reversal of ischemic retinopathy in ocular ischemic syndrome following carotid artery stenting[J/OL]. Acta Ophthalmol, 2015, 93(10): 0452 [2015-09-23]. https://doi.org/10.1111/j.1755-3768.2015.0452.
11.	Altinbas NK, Ustuner E, Ozcan H, et al. Effect of carotid artery stenting on ophthalmic artery flow patterns[J]. J Ultrasound Med, 2014, 33(4): 629-638. DOI: 10.7863/ultra.33.4.629.
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1. Lawrence PF, 0derich GS. Ophthalmologic findings as predictors of carotid artery disease[J]. Vasc Endovascular Surg, 2002, 36(6): 415-424．DOI: 10.1177/153857440203600602.
2. 魏世辉. 颈动脉狭窄引起的眼部缺血性病变[J]. 中华眼底病杂志, 2007, 23(3): 222-224．.Wei SH. Ischemic eye disease casused by carotid stenosis[J]. Chin J Ocul Fundus Dis, 2007, 23(3): 222-224．.
3. O'Brien M, Chandra A.Carotid revascularization: risks and benefits[J]. Vasc Health Risk Manag, 2014, 10: 403-416. DOI: 10.2147/VHRM.S48923.
4. Szczerbo-Trojanowska M, Jargiełło T, Drelich-Zbroja A. Management of carotid stenosis: history and today[J]. J Ultrason, 2013, 13(52): 6-20. DOI: 10.15557/JoU.2013.0001.
5. 华扬. 超声检测在颈动脉粥样硬化性狭窄评估中的价值[J]. 中国脑血管病杂志, 2006, 3(6): 241-243. DOI: 10.3969/j.issn.1672-5921.2006.06.001.Hua Y. The value of ultrasonography for detection of carotid atherosclerosis stenosis [J]. Chin J Cerebrovasc Dis, 2006, 3(6): 241-243. DOI: 10.3969/j.issn.1672-5921.2006.06.001.
6. 王敏, 王升, 陈小瑾, 等. 缺血性眼病与缺血性脑卒中发生的相关性研究[J]. 中华眼底病杂志, 2012, 28(2): 177-178. DOI: 10.3760/cma.j.issn.1005-1015.2012.02.021.Wang M, WangS, Chen XJ, et al. Study on the relationship between ischemic eye disease and ischemic stroke[J]. Chin J Ocul Fundus Dis, 2012, 28(2): 177-178. DOI: 10.3760/cma.j.issn.1005-1015.2012.02.021.
7. 黄敏慧, 郜忠海, 林列兴, 等. 颈动脉狭窄患者眼缺血表现及其影响因素分析[J]. 中华眼底病杂志, 2014, 30(5): 473-476. DOI: 10.3760/cma.j.issn.1005-1015.2014.05.011.Huang MH, Gao ZH, LinLX, et al. Ocular ischemic appearance associated with carotid artery stenosis and its influence factor[J]. Chin J Ocul Fundus Dis, 2014, 30(5): 473- 476. DOI: 10.3760/cma.j.issn.1005-1015.2014.05.011.
8. Terelak-Borys B, Skonieczna K, Grabska-Liberek I.Ocular ischemic syndrome - a systematic review[J]. Med Sci Monit, 2012, 18(8): 138-144.
9. Kiseleva TN, Tarasova LN, Fokin AA, et al. Follow-up results of surgical correction of ocular ischemic syndrome[J]. Vestn Oftalmol, 2003, 119(4): 22-24.
10. Esteban O, Nuñez E, Ascaso J, et al. Reversal of ischemic retinopathy in ocular ischemic syndrome following carotid artery stenting[J/OL]. Acta Ophthalmol, 2015, 93(10): 0452 [2015-09-23]. https://doi.org/10.1111/j.1755-3768.2015.0452.
11. Altinbas NK, Ustuner E, Ozcan H, et al. Effect of carotid artery stenting on ophthalmic artery flow patterns[J]. J Ultrasound Med, 2014, 33(4): 629-638. DOI: 10.7863/ultra.33.4.629.
12. 高颖, 李肖春, 骆丹越, 等. 颈动脉支架置入术对缺血性眼病患者眼部血流的影响[J]. 浙江医学, 2016, 38(23): 1890-1893.Gao Y, Li XC, Luo DY, et al. Effect of carotid artery stenting on ophthalmic artery blood flow in patients with ischemic ophthalmopathy[J]. Zhejiang Medical Journal, 2016, 38(23): 1890-1893.

Chinese Journal of Ocular Fundus Diseases

The effects of carotid artery stenting on ophthalmic artery blood flow in ischemic ophthalmopathy patients

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