Choroidal vascular occlusion in internal carotid artery obstruction.
OBJECTIVE
To determine choroidal vascular abnormalities in eyes with internal carotid artery obstruction (ICO).


METHODS
We examined eight eyes with ICO with wide-angle indocyanine green (ICG) video-angiography beginning in the posterior fundus. Another angiography was performed in three eyes to observe the arterial phase of the temporal peripheral fundus. ICG angiography was done until the late choroidal venous phase or for more than 10 minutes.


RESULTS
Slow dye filling in the choroidal arteries and delayed filling of the posterior watershed zone occurred in all eyes. Delayed perfusion or multiple patchy occlusions of choriocapillaris was seen in all eyes. There were delayed perfusion and/or occlusion in the peripheral watershed zone in the examined three eyes. The super-late-phase angiograms showed hyperfluorescent lines corresponding to choroidal veins.


CONCLUSIONS
Elongated arm-to-choroid circulation and delayed intrachoroidal circulation times suggest severe choroidal hypoperfusion. Choroidal hypoperfusion resulted in multiple occlusions of the choriocapillaris and attenuated choroidal vessels. Slow filling or nonperfusion of the peripheral watershed zone was another characteristic finding. Linear hyperfluorescence may reflect severely damaged choroidal venous walls. These findings are useful to understand choroidal angiopathy in ICO or high-grade stenosis, and to diagnose ocular ischemic syndrome.
Utsugi
Noriko
N
Department of Ophthalmology, Gunma University School of Medicine, Gunma, Japan.
Takahashi
Kyoichi
K
Kishi
Shoji
S
D000368:Aged; D001132:Arm / Q000098:blood supply; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000503:physiopathology; D001776:Blood Circulation Time; D002340:Carotid Artery Diseases / Q000150:complications* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000473:pathology*; D002829:Choroid / Q000098:blood supply* / Q000503:physiopathology; D015862:Choroid Diseases / Q000209:etiology* / Q000503:physiopathology; D019842:Ciliary Arteries / Q000503:physiopathology; D004396:Coloring Agents; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007498:Iris / Q000098:blood supply; D007499:Iris Diseases / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019721:Ophthalmoscopes; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000503:physiopathology
D004396:Coloring Agents; D007208:Indocyanine Green