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Carotid artery disease in patients with retinal artery occlusion
K Kimura1, Y Hashimoto, H Ohno
1Department of Cerebrovascular Disease, Kumamoto City Hospital.
Insights
Carotid artery disease, specifically severe stenosis, is a significant factor in retinal artery occlusions like central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). Plaque characteristics may also play a role.
Area of Science:
- Ophthalmology
- Vascular Neurology
- Cardiology
Background:
- Embolization from the carotid bifurcation is a leading hypothesis for central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO).
- Understanding the underlying vascular pathology is crucial for managing these vision-threatening conditions.
Purpose of the Study:
- To investigate the prevalence and characteristics of carotid artery disease in patients diagnosed with CRAO and BRAO.
- To determine the association between carotid stenosis, plaque morphology, and retinal artery occlusions.
Main Methods:
- Carotid ultrasonography was performed on 17 patients (13 males, 4 females, mean age 68.7 years) within 7 days of symptom onset.
- Assessment included evaluation of stenotic findings and plaque morphology (homogeneous vs. heterogeneous) in the internal carotid artery (ICA).
Main Results:
- A significantly higher incidence of severe carotid stenosis was observed in the internal carotid artery (ICA) ipsilateral to the affected eye compared to the contralateral side.
- No significant difference in the occurrence of heterogeneous plaques was found between the affected and non-affected ICA sides.
Conclusions:
- Severe carotid stenosis in the internal carotid artery (ICA) is strongly associated with retinal artery occlusions (CRAO and BRAO).
- While heterogeneous plaques did not show a significant difference, the combination of severe stenosis and plaque presence is suspected to be critical in the pathogenesis of retinal artery occlusion.
Abstract:
Embolization from the carotid bifurcation has been proposed as the most common cause of central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). The purpose of this study was to evaluate carotid artery disease in patients with CRAO and BRAO. Using carotid ultrasonography, 17 patients (13 males, 4 females, mean age 68.7 +/- 7.1 years) with CRAO and BRAO were examined for stenotic findings and plaque morphology (homogeneous or heterogeneous) within 7 days after onset. The internal carotid artery (ICA) ipsilateral to the affected side showed a significantly higher incidence of severe carotid stenosis as compared to the non-affected side. The occurrence of heterogeneous plaques in the ICA did not differ between the affected and the non-important affected side. We suspect that severe carotid stenosis in addition to heterogeneous plaques plays an important role in retinal artery occlusion.