[Value of Doppler carotid artery sonography in ophthalmologic diagnosis]

We report the clinical and Doppler sonographic findings on the internal carotid artery in 230 patients with various purely ocular vascular symptoms. For evaluation, the patients were subdivided into four groups: group I (107): central retinal artery obstruction (CRAO) (13), branch retinal artery obstruction (BRAO) (31), amaurosis fugax (AF) (13), anterior ischemic optic neuropathy (AION) (50); group II: retinal vein occlusion (25); group III: "low-tension glaucoma" (55); group IV: chronic open-angle glaucoma with a possible vascular co-factor (43). In group I with signs of arterial ocular mal-perfusion; 29.5% of cases with CRAO and BRAO revealed significant stenosis or complete obstruction of the ipsilateral internal carotid artery. Only 4 of 50 cases (8.0%) with AION showed positive findings. A remarkable result of this evaluation is the coincidence that nearly all high-grade obliterations and obstructions of the internal carotid arteries diagnosed in this study were exclusively confined to eyes with very severe ischemic changes in both anterior and posterior segments. In no other case was localization or extent of the obstructive process in the internal carotid artery predictive. Venous retinal obstructions with only 16% positive findings did not show any correlation with arterial occlusive disease of extracranial vessels based on demographic aspects and clinicopathological studies. Also no etiological correlation could be detected in either of the glaucoma groups (III and IV).