[Retinal hemodynamics and morphologic findings in patients with occlusion of the internal carotid artery]

Only a minor percentage of patients with occlusion of the internal carotid artery develops the clinical symptoms of ischemic ophthalmopathy. The degree of functional collateralization that mirrors the alteration in ocular perfusion seems to be of importance for its development. We employed video fluorescein angiography to determine the degree of minor retinal perfusion in 33 patients. With a picture analyzer (Microvideomat 3, Zeiss) we quantified the arm-retina time (ART), the arteriovenous passage time (AVP) and the arterial dye bolus velocity. In these patients retinal perfusion was significantly decreased compared to a normal control group. The AVP of 18 patients was more than triple the average normal value (1.45 +/- 4.0 s); 3 of these patients showed morphological signs of ischemic ophthalmopathy with extensive non-perfusion areas: they showed a change in retinal hemodynamics and a massive deficiency in vasomotor response to CO2 stimulation. After panretinal laser coagulation their retinal hemodynamics, morphological alterations and subjective complaints improved. Our results show that using video fluorescein angiography on patients suffering from occlusion of the internal carotic artery analyzing the retinal hemodynamics can help to determine whether ischemic ophthalmopathy is developing or not.