Perimetric and retrobulbar blood flow changes following carotid endarterectomy.
BACKGROUND
Carotid stenosis can produce visual changes. This study examines perimetric and retrobulbar blood flow changes following carotid endarterectomy (CEA) in patients without visual symptoms.


METHODS
Sixteen patients (13 male, three female) with bilateral carotid stenosis were included. Patients with a history of ophthalmic disease, including glaucoma, were excluded. Peak systolic velocity (PSV) in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCAs) was measured preoperatively and 12 months following CEA with color Doppler imaging (CDI), using a 7.5 MHz probe, at both the side operated upon and its fellow side. Automated static perimetry (Octopus 500 perimeter, G1x program) was performed at the same intervals. Mean sensitivity (MS), mean defect (MD), loss variance (LV) and corrected loss variance (CLV) were recorded.


RESULTS
Preoperative PSV in the OA was significantly lower in the side operated on. Preoperative perimetric parameters were significantly compromised, compared with normative data, in both eyes. Postoperatively, PSV had significantly improved in all vessels examined in the carotid that was operated on, but only in the OA and SPCAs in the fellow side. MD had significantly improved postoperatively for both eyes, whereas improvement in the other perimetric parameters examined was not statistically significant.


CONCLUSIONS
Perimetric changes occur in carotid stenosis. CEA results in the improvement of retrobulbar blood flow and perimetric parameters. Further research will be required to determine whether perimetric parameters may be used as additional indicators for carotid endarterectomy.
Kozobolis
Vassilios P
VP
Department of Ophthalmology, University Hospital of Alexandroupolis, Demokritus University of Thrace, Thrace, Greece.
Detorakis
Efstathios T
ET
Georgiadis
George S
GS
Achtaropoulos
Athanassios A
AA
Papas
Theofanis T
TT
Lazarides
Miltos K
MK
D000368:Aged; D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000503:physiopathology / Q000601:surgery; D016893:Carotid Stenosis / Q000503:physiopathology* / Q000601:surgery; D019842:Ciliary Arteries / Q000502:physiology*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000502:physiology*; D009915:Orbit / Q000098:blood supply*; D011446:Prospective Studies; D012039:Regional Blood Flow; D012161:Retinal Artery / Q000502:physiology*; D058609:Visual Field Tests