Central retinal vein obstruction and carotid artery disease

Thirty-seven consecutive patients (39 eyes) with a central retinal vein obstruction (CRVO) were studied in a cross-sectional fashion with intravenous fluorescein angiography and digitial subtraction carotid angiography. Among the 35 patients (37 eyes) with acceptable studies, 24 eyes, (64%) had an ischemic CRVO, 12 (33%) demonstrated a nonischemic CRVO, and one (3%) was indeterminate. A 17% incidence of ipsilateral atherosclerotic carotid artery obstruction greater than or equal to 50% was associated with both the ischemic (4/24 eyes) and nonischemic (2/12 eyes) groups. Overall, 13 of 35 (37%) patients with CRVO had demonstrable common or internal carotid artery atherosclerosis, an incidence no higher than found in a historical control sample studied postmortem. However, this incidence rose to 50% in patients with an ischemic CRVO and decreased to 17% in those with the nonischemic variety.