Investigation of macular and optic nerve head structural changes using spectral domain optical coherence tomography in internal carotid artery stenosis

Author(s):  
Kenan Dagdelen ◽  
Omer Ersin Muz
2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Anna Machalińska ◽  
Aleksandra Kowalska-Budek ◽  
Miłosz Piotr Kawa ◽  
Arkadiusz Kazimierczak ◽  
Krzysztof Safranow ◽  
...  

Purpose. This study was designed to assess retinal and optic nerve bioelectrical function in patients with unilateral asymptomatic but hemodynamically significant internal carotid artery stenosis (ICAS).Methods. Forty-two subjects with a diagnosis of unilateral ICAS and 34 controls were analyzed. Full-field electroretinogram (ERG), pattern electroretinogram (PERG), and pattern visual-evoked potentials, as well as optical coherence tomography and ophthalmological examination, were performed. Data analysis included eyes ipsilateral to ICAS (EIS) and eyes contralateral to ICAS (ECS).Results. Intraocular pressure was significantly decreased in EIS and ECS compared to that in the controls. In the macula, both the cube average thickness and cube volume values were significantly reduced both in EIS and ECS compared to those in the controls. Similarly, PERG P50 and N95 wave amplitudes were significantly smaller in EIS and ECS compared to those in the controls. The ERG rod b-wave and rod-cone a-wave amplitudes were decreased, and implicit times were significantly prolonged, whereas the OP wave index was reduced in EIS compared to that in the controls. No differences in IOP, OCT, or ERG and PERG parameters were identified between EIS and ECS.Conclusions.Our study demonstrated that retinal bioelectrical function is negatively affected by ICAS despite the absence of objective clinical signs and symptoms of ocular ischemia.


1964 ◽  
Vol 51 (9) ◽  
pp. 703-709 ◽  
Author(s):  
P. H. Dickinson ◽  
John Hankinson ◽  
Merlin Marshall

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Saqib A Chaudhry ◽  
Peter A Ringleb

Background: Extracranial vertebral artery disease is seen in patients with internal carotid artery stenosis although the clinical significance not well understood. Methods: We analyzed data that was collected as part of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) trial which recruited patients with recently symptomatic internal carotid artery stenosis. We used Cox proportional hazards analysis to compare the relative risk of various endpoints between the three categories of extracranial vertebral artery disease (normal/hypoplastic, moderate/severe stenosis, and occlusion). The multivariate analyses were adjusted for age, gender, basic demographics and severity of carotid stenosis. Results: Of the 1181 subjects who had extracranial vertebral artery ultrasound evaluation, moderate to severe stenosis and occlusion of one of both extracranial vertebral arteries was diagnosed in 152(12.9%) and 57(4.8%) subjects, respectively. During the mean follow up period (±SD) of 22.1±7.1 months 102(8.6%) and 60(5.1%) experienced a stroke or died, respectively. Compared with subjects with normal or hypoplastic vertebral artery, there was a non-significant 30% higher risk of any stroke among subjects with moderate to severe vertebral artery stenosis (relative risk [RR]1.3, 95% confidence interval [CI]0.7-2.3) after adjusting for potential confounders. There was a 40% and 50% higher risk of ipsilateral stroke (RR 1.4, 95% CI0.7-2.5) and death (RR 1.5, 95% CI 0.7-3.1) among subjects with moderate to severe vertebral artery stenosis after adjusting for potential confounders. In Kaplan Meir analysis, the estimated 1 and 2 year stroke free survival for subjects with moderate to severe vertebral artery stenosis was 88% (standard error [SE]2.6%). In comparison, the estimated 1 and 2 year stroke free survival for subjects with normal or hypoplastic vertebral artery was 92.5%(SE0.8%)and 91.6%(SE0.9), respectively. Conclusions: There appears to be an increased risk of stroke and death in patients with symptomatic internal carotid artery stenosis with concurrent asymptomatic extracranial vertebral artery stenosis.


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