[Carotid ultrasonographic and brain computerized tomographic findings in patients with vascular ocular syndromes].
To clarify the characteristics of cerebrovascular lesions in subtypes of vascular ocular syndrome, including amaurosis fugax(AF), retinal artery occlusion(RAO), and retinal vein occlusion(RVO), 93 patients with vascular ocular syndrome were studied by means of carotid ultrasonography(US) and brain computerized tomography(CT). The subjects comprised 21 patients with AF, 37 with RAO, and 35 with RVO who were sequentially given these diagnoses by the department of ophthalmology. On the basis of US findings, carotid lesions were defined as the presence of plaque or stenotic changes. CT findings were assessed for the presence and distribution of low-density areas(LDAs). Mean age was similar in each group, ranging from 64.5 to 67.4 years. The RAO group had high rates of men, hypertension, and smokers. US showed that the prevalence of carotid lesions ipsilateral to the affected eye was high in the RAO group and that severe stenosis and ulcerated plaque were present in 28.6% of the AF group and 45.9% of the RAO group. On CT examination, cerebral infarctions appeared as LDAs in about 10% of the patients in each group, and the incidence and distribution of LDAs were similar. Of 13 patients with cerebral infarction, only 2 were presumably due to carotid lesions; the others had a variety of causes. The discrepancy between US and CT findings was attributed to the small number of patients with cerebral infarction, since most patients had visual defects as an initial symptom. Our results suggest that extracranial carotid lesions, considered to be a major risk factor for stroke, should be carefully assessed in patients with AF or RAO to prevent further stroke.
Iwamoto
Toshihiko
T
Department of Geriatric Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Matsushima
Chikage
C
Shimizu
Souichirou
S
Takasaki
Masaru
M
Iwasaki
Takuya
T
Usui
Masahiko
M
D000368:Aged; D020757:Amaurosis Fugax / Q000000981:diagnostic imaging* / Q000209:etiology; D001921:Brain / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000000981:diagnostic imaging* / Q000209:etiology; D015356:Retinal Artery Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography