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Ischemic Oculopathy: A Manifestation of Carotid Artery Disease

Ischemic Oculopathy: A Manifestation of Carotid Artery Disease Abstract • Six patients experienced ischemic oculopathy, a condition in which there is ischemia in both the anterior and posterior segments of the eye caused by occlusive carotid artery disease. The abnormalities in the anterior segment include episcleral vascular congestion, anterior chamber flare and cells, a mid-dilated, sluggish, or unreactive pupil, rubeosis iridis, and abnormal intraocular pressure. The posterior segment abnormalities include ischemic insults to the retina or optic nerve, venous-stasis retinopathy, and low ophthalmodynamometry values. Ophthalmodynamometry is particularly helpful in recognizing the pathogenesis of this disorder. Superficial temporal artery-middle cerebral artery anastomosis surgery may have particular merit for patients with ischemic oculopathy. References 1. Kearns TP, Hollenhorst RW: Venous-stasis retinopathy of occlusive disease of the carotid artery . Mayo Clin Proc 1963;38:304-312. 2. Kearns TP: Ophthalmology and the carotid artery . Am J Ophthalmol 1979;88:714-722. 3. Knox DL: Ischemic ocular inflammation . Am J Ophthalmol 1965;60:995-1002. 4. Walsh FB, Hoyt WF: Vascular lesions and circulatory disorders of the nervous system , in Walsh FB, Hoyt WF (eds): Clinical Neuroophthalmology . Baltimore, Williams & Wilkins Co, 1969, pp 1831-1834. 5. Bullock JD, Falter RT, Dowing JE, et al: Ischemic ophthalmia secondary to an ophthalmic artery occlusion . Am J Ophthalmol 1972;74:486-493. 6. Hollenhorst RW: Ocular manifestations of insufficiency or thrombosis of the internal carotid artery . Am J Ophthalmol 1959;47:753-767. 7. Hollenhorst RW: Carotid and vertebro-basilar arteriolar stenosis and occlusion: Neuro-ophthalmologic considerations . Ophthalmology 1962;66:166-180. 8. Hedges TR: Ophthalmoscopic findings in internal carotid artery occlusion . Bull Johns Hopkins Hosp 1962;111:89-97. 9. Hedges TR: The aortic arch syndromes . Arch Ophthalmol 1964;71:62-68. 10. Smith JL: Unilateral glaucoma in carotid occlusive disease . JAMA 1962;182:683-684.Crossref 11. Kearns TP, Siekert RG, Sundt TM: The ocular aspects of bypass surgery of the carotid artery . Mayo Clin Proc 1979;54:3-11. 12. Swan KC, Raaf J: Changes in the eye and orbit following carotid ligation . Trans Am Ophthalmol Soc 1951;49:435-444. 13. Kobayashi S, Hollenhorst RW, Sundt TM: Retinal arterial pressure before and after surgery for carotid artery stenosis . Stroke 1971;2:569.Crossref 14. Batko KA, Appen RE: Ophthalmodynamometry: A reappraisal . Ann Ophthalmol 1979;11:1499-1508. 15. Olivarius BF: External carotid artery sign . Acta Neurol Scand 1965;41:539-550.Crossref 16. Fisher CM: Facial pulses in internal carotid artery occlusion . Neurology 1970;20:476-478.Crossref 17. Thompson JE, Austin DJ, Patman RD: Endarterectomy of the totally occluded carotid artery for stroke: Results in 100 operations . Arch Surg 1967;95:791.Crossref 18. Thompson JE, Talkington CM: Carotid endarterectomy . Ann Surg 1976;184:1-15.Crossref 19. Yasargil MG: Diagnosis and indications for operations in cerebrovascular occlusive disease , in Yasargil MG (ed): Microsurgery Applied to Neurosurgery . Stuttgart, West Germany, Georg Thieme Verlag, 1969, pp 95-119. 20. Yasargil MG, Krayanbuhl HA, Jacobson JH: Microneurosurgical arterial reconstruction . Surgery 1970;67:221-233. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Ischemic Oculopathy: A Manifestation of Carotid Artery Disease

Archives of Neurology , Volume 38 (6) – Jun 1, 1981

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Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1981.00510060060009
Publisher site
See Article on Publisher Site

Abstract

Abstract • Six patients experienced ischemic oculopathy, a condition in which there is ischemia in both the anterior and posterior segments of the eye caused by occlusive carotid artery disease. The abnormalities in the anterior segment include episcleral vascular congestion, anterior chamber flare and cells, a mid-dilated, sluggish, or unreactive pupil, rubeosis iridis, and abnormal intraocular pressure. The posterior segment abnormalities include ischemic insults to the retina or optic nerve, venous-stasis retinopathy, and low ophthalmodynamometry values. Ophthalmodynamometry is particularly helpful in recognizing the pathogenesis of this disorder. Superficial temporal artery-middle cerebral artery anastomosis surgery may have particular merit for patients with ischemic oculopathy. References 1. Kearns TP, Hollenhorst RW: Venous-stasis retinopathy of occlusive disease of the carotid artery . Mayo Clin Proc 1963;38:304-312. 2. Kearns TP: Ophthalmology and the carotid artery . Am J Ophthalmol 1979;88:714-722. 3. Knox DL: Ischemic ocular inflammation . Am J Ophthalmol 1965;60:995-1002. 4. Walsh FB, Hoyt WF: Vascular lesions and circulatory disorders of the nervous system , in Walsh FB, Hoyt WF (eds): Clinical Neuroophthalmology . Baltimore, Williams & Wilkins Co, 1969, pp 1831-1834. 5. Bullock JD, Falter RT, Dowing JE, et al: Ischemic ophthalmia secondary to an ophthalmic artery occlusion . Am J Ophthalmol 1972;74:486-493. 6. Hollenhorst RW: Ocular manifestations of insufficiency or thrombosis of the internal carotid artery . Am J Ophthalmol 1959;47:753-767. 7. Hollenhorst RW: Carotid and vertebro-basilar arteriolar stenosis and occlusion: Neuro-ophthalmologic considerations . Ophthalmology 1962;66:166-180. 8. Hedges TR: Ophthalmoscopic findings in internal carotid artery occlusion . Bull Johns Hopkins Hosp 1962;111:89-97. 9. Hedges TR: The aortic arch syndromes . Arch Ophthalmol 1964;71:62-68. 10. Smith JL: Unilateral glaucoma in carotid occlusive disease . JAMA 1962;182:683-684.Crossref 11. Kearns TP, Siekert RG, Sundt TM: The ocular aspects of bypass surgery of the carotid artery . Mayo Clin Proc 1979;54:3-11. 12. Swan KC, Raaf J: Changes in the eye and orbit following carotid ligation . Trans Am Ophthalmol Soc 1951;49:435-444. 13. Kobayashi S, Hollenhorst RW, Sundt TM: Retinal arterial pressure before and after surgery for carotid artery stenosis . Stroke 1971;2:569.Crossref 14. Batko KA, Appen RE: Ophthalmodynamometry: A reappraisal . Ann Ophthalmol 1979;11:1499-1508. 15. Olivarius BF: External carotid artery sign . Acta Neurol Scand 1965;41:539-550.Crossref 16. Fisher CM: Facial pulses in internal carotid artery occlusion . Neurology 1970;20:476-478.Crossref 17. Thompson JE, Austin DJ, Patman RD: Endarterectomy of the totally occluded carotid artery for stroke: Results in 100 operations . Arch Surg 1967;95:791.Crossref 18. Thompson JE, Talkington CM: Carotid endarterectomy . Ann Surg 1976;184:1-15.Crossref 19. Yasargil MG: Diagnosis and indications for operations in cerebrovascular occlusive disease , in Yasargil MG (ed): Microsurgery Applied to Neurosurgery . Stuttgart, West Germany, Georg Thieme Verlag, 1969, pp 95-119. 20. Yasargil MG, Krayanbuhl HA, Jacobson JH: Microneurosurgical arterial reconstruction . Surgery 1970;67:221-233.

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1981

References