ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Comparing retinal vascular changes in patients who underwent carotid endarterectomy
Macit Bitargil1, Caner Arslan1, Elmar Bayraktarov2, Pınar Sultan3, Fatih Kantarcı2, Hamit Serdar Başbuğ4, Kazım Beşirli1, Kamil Hasan Tüzün1
İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, İstanbul, Türkiye
1İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, İstanbul, Türkiye
2 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye
3İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, İstanbul, Türkiye
4Kafkas Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, Kars, Türkiye
DOI : 10.5606/tgkdc.dergisi.2014.9434
Background: This study aims to investigate ocular ischemia in patients who were candidates for carotid endarterectomy (CEA) and postoperative flow changes in orbital arteries, and demonstrate the impact of these flow changes on the eye and ocular ischemia.

Methods: Thirty patients (23 males, 7 females; mean age 68.1±7.61 years; range 47 to 82 years) who were planned to undergo CEA due to critical carotid artery stenosis between November 2011 and May 2012 were analyzed prospectively. Fundus examination, visual acuity measurement and intra ocular pressure measurement were performed, and color fundus images were taken with fundoscopy preoperatively. Central retinal artery (CRA) and ophthalmic artery (OA) flows were measured with orbital color Doppler ultrasound (RDUS). The same procedures were repeated postoperatively, and findings were compared. These flow findings were compared with findings of a control group which was composed of 20 volunteers (14 males; 6 females, mean age 47.5±9.9 years) without carotid artery stenosis.

Results: Ten out of 30 patients (33.3%) had initial findings of ocular ischemic syndrome (OIS). Pre-CEA retinal artery peak systolic velocity (PSV) values of patients with initial findings of OIS were significantly lower compared to values of patients without initial findings of OIS and the control group. Significantly increased post- CEA retinal artery PSV values were detected for all these patients. While increased visual acuity was detected in five of the 10 patients (50%) with initial findings of OIS, there was no change in five patients.

Conclusion: Severe carotid artery stenosis may lead to ocular ischemia, retinal embolus, and OIS. These pathologies can be demonstrated via orbital RDUS and retinal photography. Carotid endarterectomy may regulate the reduced ocular blood flow, and support ocular healing.

Keywords : Carotid endarterectomy; ocular ischemia; retinal artery
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