Visual outcomes in carotid stenosis patients treated using endarterectomy.

IF 0.6 Q4 SURGERY Polish Journal of Surgery Pub Date : 2023-01-26 DOI:10.5604/01.3001.0016.2123
Aleksandra Krasińska-Płachta, Agata Brązert, Joanna Mamczur-Załęcka, Marcin Gabriel, Michał Suchodolski, Beata Begier-Krasińska, Jarosław Kocięcki
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Abstract

IntroductionCarotid arthrosclerosis can be a cause of visual impairment. It has been observed that carotid endarterectomy has a positive effect on ophthalmic parameters. The aim of this study was to evaluate the impact of endarterectomy on the optic nerve function.Materials and methods54 asymptomatic patients (19 women and 35 men - 108 eyes) with unilateral carotid stenosis >70% of internal carotid artery, were recruited to the study. All of them were qualified for the endarterectomy procedure. The whole study group underwent Doppler ultrasonography of internal carotid arteries and ophthalmic examination before the surgery, with 22 of them (11 women and 11 men) were examined after the endarterectomy. The ophthalmic examination included; distant best-corrected visual acuity, measurement of the intraocular pressure, electrophysiology (pattern visual evoked potentials), perimetry, and optical coherent tomography (the retinal nerve fiber layer thickness).DiscussionCarotid arteries supply brain and face with blood. Extensive research has observed a concomitant improvement in eyesight after enduring carotid endarterectomy in patients with artery stenosis. This effect was associated with a better blood flow in the ophthalmic artery and its branches, the central retinal artery and the ciliary artery; the major blood supply of the eye.ResultsThe present study proved that carotid endarterectomy has a positive impact on the function of the optic nerve. The visual field parameters and amplitude of pattern visual evoked potentials significantly improved. Preoperative and postoperative values of intraocular pressure and the retinal nerve fiber layer thickness remained stable.

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颈动脉内膜切除术治疗颈动脉狭窄患者的视觉效果。
颈动脉关节硬化可引起视力损害。观察到颈动脉内膜切除术对眼科参数有积极的影响。本研究的目的是评估动脉内膜切除术对视神经功能的影响。材料与方法选取单侧颈动脉狭窄占颈内动脉70%的54例无症状患者(女19例,男35例,108眼)作为研究对象。所有患者均符合动脉内膜切除术的条件。整个研究组术前均行颈内动脉多普勒超声检查及眼科检查,其中22例(女11例,男11例)行动脉内膜切除术后复查。眼科检查包括:远视最佳矫正视力、眼内压测量、电生理(模式视觉诱发电位)、视野测量和光学相干断层扫描(视网膜神经纤维层厚度)。颈动脉为大脑和面部供血。广泛的研究发现,在动脉狭窄患者接受颈动脉内膜切除术后,视力得到改善。这种效果与眼动脉及其分支、视网膜中央动脉和睫状动脉的血流改善有关;眼睛的主要血液供应。结果本研究证实颈动脉内膜切除术对视神经功能有积极影响。视野参数和模式视觉诱发电位振幅明显改善。术前、术后眼压值及视网膜神经纤维层厚度保持稳定。
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