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[Ocular subclinical changes in significant carotid stenosis]
D Hejcmanová1, J Svĕrák, V Hobza
1Ocní klinika FN, Hradec Králové.
Summary
High-grade carotid stenosis can cause visual field defects and retinal function disorders, even with normal eye exams. Automated perimetry and electroretinography aid in detecting these early changes.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Context:
- High-grade carotid stenosis affects cerebrovascular health.
- Ocular changes are often absent despite neurological symptoms.
- Automated perimetry and electroretinography are key diagnostic tools.
Purpose:
- To investigate visual field defects and retinal function in patients with high-grade carotid stenosis.
- To assess the utility of perimetry and electroretinography in detecting early retinal alterations.
- To explore the correlation between stenosis severity and visual/retinal findings.
Summary:
- 41 out of 58 patients with high-grade carotid stenosis exhibited visual field defects.
- Electroretinography revealed decreased oscillatory potential amplitudes and prolonged latencies, particularly on the ipsilateral side.
- Significant amplitude decrease in OP2 was noted post-amaurosis fugax, with a critical value of 37 muV.
Impact:
- High-grade carotid stenosis is linked to visual field defects and retinal dysfunction, even with normal fundus findings.
- Decreased arterial perfusion or microembolization are potential causes.
- Perimetry and ERG are valuable for early detection of retinal alterations and guiding carotid endarterectomy decisions.