Effect of carotid endarterectomy on chronic ocular ischemic syndrome in bilateral carotid artery disease complicated with transient ischemic attacks

Abstract

We evaluated the effect of carotid endarterectomy on chronic ocular ischemic syndrome (OIS) with transient ischemic attacks (TIAs). Twenty patients were examined with OIS due to carotid stenosis (>80% stenosis); 17 men and 3 women (mean age 66.7 ± 6.5 (34-77)). Preoperatively, dominant ocular sign was diagnosed as amaurosis fugax in 14 patients, quarantanopia in 2, and blindness in 1. The ophthalmic artery flow directions were reversed in 11 patients and antegrade in 9. In nine patients who experienced antegrade ophthalmic artery flow, the average peak systolic flow velocity was -0.029 ± 0.05 m/s. All patients showed antegrade ophthalmic artery flow after surgery. The average peak systolic flow velocity in the patients measuring 24 hours after operation, 0.32 ± 0.14 m/s. There were no significant change among the first day findings at 1 week, 1 month and 3 months after endarterectomy. During the follow-up period (mean, 28.4 ± 4.6 months (11-53)), no patients complained of recurrent visual symptoms. Carotid endarterectomy was effective for improving or preventing the progress of COI caused by internal carotid artery stenosis. © 2009 Informa UK Ltd.