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  • Effect of CEA and CAS for Ocular Circulation and Chronic Ocular Ischemic Syndrome

    Final Number:

    Shoichiro Kawaguchi MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Background: We evaluated the effect of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for ocular circulation and chronic ocular ischemic syndrome (OIS).

    Methods: Methods: We examined ninety-3 patients with carotid artery stenosis (more than 50% stenosis) at its origin treated by CEA (N=58) or CAS (N=35). Twenty-six patients (28%) complained of chronic OIS. Ocular circulation was evaluated before and after revascularization surgery using ophthalmic artery (OphAr) and central retinal artery (CRA) color Doppler flow imaging.

    Results: Results: 1) Ocular circulation: Preoperatively, the average OphAr peak systolic flow velocity (Vs) was 0.05 m/sec, and the average CRA Vs was 0.07 m/sec. At 1 week after surgery, the average OphAr Vs significantly increased to 0.32 m/sec (p < 0.05), and the average CRA Vs significantly increased to 0.11 m/sec (p < 0.05). These significant improvements were sustained throughout the three months of the follow up.2) OIS: During the follow-up period (mean: 3.8 years), 16 patients (62%) showed visual acuity improvement, and no patients complained of amaurosis fugax or worsening of the chronic OIS.

    Conclusions: Conclusion: Carotid revascularization surgery was effective in improving the ocular circulation, and it was also useful for the chronic OIS due to the carotid artery stenosis.

    Patient Care: CEA and CAS can improve the prognosis of the chronic ocular ischemic syndrome, and those can prevent it.

    Learning Objectives: Participants can learn the effect of the carotid revascularization surgery (CEA and CAS) for the ocular circulation and the chronic ocular ischemic syndrome.


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