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Cerebral microembolism in patients with retinal ischemia
C A Wijman1, V L Babikian, I C Matjucha
1Department of Neurology, Boston University School of Medicine, Mass., USA.
Stroke
|June 17, 1998
Summary
Cerebral microembolism is common in patients with retinal ischemia, especially within a week of symptom onset. This condition often correlates with severe carotid artery stenosis or occlusion.
Area of Science:
- Neuroscience
- Vascular Neurology
- Ophthalmology
Background:
- Retinal ischemia, including transient monocular blindness and retinal artery infarction, can be linked to embolic events.
- Cerebral microembolism is a potential source of such events, but its frequency in retinal ischemia patients is not well-established.
Purpose of the Study:
- To determine the incidence of cerebral microembolism in patients with clinical evidence of retinal ischemia.
- To investigate the association between cerebral microembolism and carotid artery stenosis in these patients.
Main Methods:
- Retrospective review of 331 patients with retinal ischemia, excluding cardiac embolic sources.
- Transcranial Doppler ultrasonography used for microembolus detection in middle cerebral arteries (MCAs).
- Carotid artery stenosis quantified by angiography or duplex studies.
Main Results:
- Cerebral microembolism detected in 40.0% of MCAs ipsilateral to the symptomatic eye versus 9.2% in controls.
- Detection rate was higher within one week of symptom onset (61.9%) compared to later (20.8%).
- Severe carotid stenosis (≥70%) or occlusion was more frequent in patients with microembolism.
Conclusions:
- Cerebral microembolism is frequently detected in patients with retinal ischemia, particularly in the acute phase.
- The presence of microembolism is often associated with significant ipsilateral carotid artery stenosis or occlusion.