title: Usefulness of laser speckle flowgraphy for the assessment of ocular blood flow in extracranial-intracranial bypass.
abstract: Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus. The authors present a case of symptomatic internal carotid artery occlusion treated with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in which an improvement of ocular circulation was confirmed by LSFG. A 47-year-old man presented with a 1-month history of repeated left blurred vision and motor weakness of the right leg. Diffusion-weighted magnetic resonance imaging revealed a small infarction in the left frontal lobe. Carotid angiography revealed that the left internal carotid artery was occluded at the C4 portion. Single-photon emission computed tomography indicated that the cerebral blood flow in the left MCA territory was markedly impaired. Ophthalmologic examination revealed ischemic change of the left optic fundi, and LSFG revealed decreased blood flow around the left optic disc. Left STA-MCA bypass was successfully performed. Both ischemic ocular symptoms and the ischemic symptoms of the right leg were completely recovered after surgery. Postoperative ophthalmologic examination revealed improvement of both ischemic changes of the left optic fundi. Moreover, LSFG revealed improvement of the blood flow around the left optic disc. LSFG can be a promising clinical tool for the assessment of ocular circulation before and after bypass surgery for occlusive cerebrovascular disease.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Omodaka
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Japan. Electronic address: hideendo@gmail.com.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Endo
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.affiliation: Department of Neurosurgery, Akita University Hospital, Akita, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Aizawa
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakazawa
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D009898:Optic Disk / Q000098:blood supply*; D011237:Predictive Value of Tests; D011859:Radiography; D012039:Regional Blood Flow; D013699:Temporal Arteries / Q000503:physiopathology / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D058017:Vascular Grafting; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology
keywords: Laser speckle flowgraphy; STA-MCA bypass; internal carotid artery occlusion; ocular ischemic syndrome; venous stasis retinopathy