[Arterial occlusive diseases of the eye. Diagnostic contribution of Doppler sonography].

In a retrospective study, patients with 125 ocular arterial occlusions (71 men, 54 women) observed between 1978 and 1981 were analyzed with regard to etiology, therapy, and course of disease. Particular attention was given to information obtained by means of Doppler sonography. Among our patients the most common condition was occlusion of either the central retinal artery or its branches (62 cases), as opposed to 30 patients with apoplexia papillae, 6 with chronic ocular ischemia (or ischemic ophthalmopathy), and 4 with less common types of occlusion. In the patient collective as a whole, the causes in those over 50 years of age are predominantly hypertony, arteriosclerosis, and emboli, as well as other causes which cannot be determined with certainty. If occlusions of the central artery and its branches and amaurosis fugax are considered alone, emboli are by far the most common cause. According to the findings with Doppler sonography, the most frequent source of emboli appears to be the bifurcation of the carotid artery. A chronic ocular ischemia (also known as ischemic ophthalmopathy) is always indicative of obstruction of the carotid artery. The situation is completely different in apoplexia papillae, which is, as a rule, either secondary to an affection of the smaller vessels, hypertonically arteriosclerotic, or caused by inflammation, as is the case in temporal arteriitis. Doppler sonography is of paramount importance as a simple, non-invasive method for determining the pathogenesis of ocular arterial occlusion. It also provides pointers to further clarifications which could lead to bypass surgery being indicated. In those patients in whom such examinations were possible, the findings were pathologic in all cases of chronic ocular ischemia (6 out of 6), in 84% of the cases of amaurosis fugax, in 62.5% of the cases of occlusion of the central artery or its branches, but only in 23% of the cases of apoplexia papillae, which further distinguishes this later condition from the other forms of occlusion. Frequently suggested therapies, for example RheomacrodexR, failed to produce any convincing results in our patient collective - not only those with central arterial thrombosis but also those with apoplexia papillae. In a statistical comparison, no significant difference could be demonstrated between our treatment of apoplexia papillae without corticosteroids (as long as arteriitis temporalis was not involved) and that of Hayreh, who administered corticosteroid treatment not only for apoplexia papillae but also for arteriosclerotic conditions of the optic disk induced by hypertension.(ABSTRACT TRUNCATED AT 400 WORDS)