Kawaguchi Shoichiro, Iida Jun-Ichi, Uchiyama Yoshitomo
Department of Neurosurgery, Nara Prefectural Nara Hospital, Nara 631-0846, Japan.
J Ophthalmol. 2012;2012:350475. doi: 10.1155/2012/350475. Epub 2012 Dec 20.
Background. We evaluated the effect of carotid revascularization surgery on ocular circulation and chronic ocular ischemic syndrome (OIS). Methods. We examined ninety patients with carotid artery stenosis (more than 50% stenosis) at its origin treated with carotid endarterectomy (N = 56) or carotid artery stenting (N = 34). Twenty-five patients (28%) complained of chronic OIS. Ocular circulation was examined before and after revascularization surgery using ophthalmic artery (OphAr) and central retinal artery (CRA) color Doppler flow imaging. 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 (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 followup. (2) OIS: during the follow-up period (mean: 3.6 years), 15 patients (60%) showed visual acuity improvement, and no patients complained of amaurosis fugax or worsening of the chronic OIS. 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.
背景。我们评估了颈动脉血运重建手术对眼循环和慢性眼部缺血综合征（OIS）的影响。方法。我们检查了90例起源处颈动脉狭窄（狭窄超过50%）并接受颈动脉内膜切除术（N = 56）或颈动脉支架置入术（N = 34）的患者。25例患者（28%）主诉患有慢性OIS。使用眼动脉（OphAr）和视网膜中央动脉（CRA）彩色多普勒血流成像在血运重建手术前后检查眼循环。结果。（1）眼循环：术前，平均OphAr收缩期峰值血流速度（Vs）为0.05米/秒，平均CRA Vs为0.07米/秒。术后1周，平均OphAr Vs显著增加至0.32（P < 0.05），平均CRA Vs显著增加至0.11米/秒（P < 0.05）。这些显著改善在整个三个月的随访期间持续存在。（2）OIS：在随访期间（平均：3.6年），15例患者（60%）视力改善，无患者主诉一过性黑矇或慢性OIS恶化。结论。颈动脉血运重建手术在改善眼循环方面有效，并且对因颈动脉狭窄导致的慢性OIS也有用。
