[Eye changes in stenoses of the internal carotid artery--histologic and clinical findings]

From a group of 26 patients with proven stenosis or occlusion of the internal carotid artery, 8 were selected who had typically developing chronic ischemia of the globe. Four eyes had to be enucleated due to painful secondary glaucoma. The results of histological examination correlated with the clinical findings, showing fibrovascular occlusion of the chamber angle with incipient endothelialization, pronounced hyalinization of the ciliary body, venous stasis of the choroidal and retinal circulation, and a predominantly perivenous lymphocytic infiltration of the optic nerve. The causal mechanisms are discussed. Particular attention is given to blood flow factors in the orbital area (in 5 of the 8 patients Doppler sonography showed a reversal of flow in the supratrochlear artery on the same side as the globe ischemia). Diagnosis and therapy require an interdisciplinary approach, since besides treating the ophthalmological complications it is vital to ensure stroke prophylaxis by improving cerebral circulation.