Incidence of ocular ischemic syndrome in patients with asymptomatic severe internal carotid artery stenosis.

OBJECTIVES

To evaluate the incidence of ocular ischemic syndrome (OIS) in patients with asymptomatic Severe Internal Carotid Artery Stenosis or occluded (ipICA-SO).

DESIGN AND METHODS

260 patients with ipICA stenosis ≥ 70%, 120 patients with ipsilateral OIS, and 140 with normal ocular condition. The logistic regression analysis was conducted to establish risk prediction models of OIS/Neovascular-OIS/Chronic-OIS for patients with ipICA-SO. The area under the receiver operating characteristic curve (AUC) was used to test the application value of the prediction models.

RESULTS

In ipICA-SO patients, OIS patients showed significantly higher incidence of ipICA occlusion (p < 0.001), plaque unstable (p < 0.001 ipsilateral/contralateral) or plaque located at both the primary and siphon section (p = 0.004 in ipsilateral), contralateral ICA or anterior/middle cerebral artery severe stenosis (p = 0.001, 0.016, 0.040, respectively), and ipsilateral OphAr low /reflux blood flow (p < 0.001). The hypertension was significantly higher in the control group (p = 0.002). The AUC of the prediction model of OIS was 0.834. Diabetes mellitus (DM) and OphAr reflux blood flow are risk factors for Neovascular-OIS. The AUC of Neovascular-OIS was 0.724. Chronic progress is likely in OIS patients with ipICA occlusion and DM. The AUC of Chronic-OIS was 0.673.

CONCLUSIONS

The ipICA-SO patients without sufficient collateral flow are more likely to develop OIS. IpICA-SO patients with hypertension had a lower risk of developing OIS. Neovascular was commonly found in OIS patients with DM and reversed OphAr blood flow. Chronic OIS was associated with ipICA total occlude and DM.