Effects of superficial temporal to middle cerebral artery bypass for ischaemic retinopathy due to internal carotid artery occlusion/stenosis.

The effects of superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis for retinopathy is discussed and analysed in 19 cases of occlusive internal carotid artery disease (4 with stenosis and 15 with occlusion) according to Doppler sonography (DS) of the retinal artery, optic fundi and visual impairment symptoms. Preoperatively, all cases showed abnormal DS findings (stenosis patterns in 2 cases and the reversed flow patterns in 17 cases). All cases showed ischaemic changes of the optic fundi. Visual symptoms were amaurosis fugax in 2 cases, decline of visual acuity in 13 cases and both in 4 cases. At one month after the bypass, two stenosis pattern cases showed almost normal DS findings. In the 17 reversed flow pattern cases, 13 cases had a marked improvement of the reversed flow. The ischaemic changes of the optic fundi were ameliorated in 12 cases. In the follow-up stage, greater improvement in the DS findings and the optic fundi could be seen in all cases. In all cases worsening of the visual acuity was prevented, and in some cases the decreased visual acuity improved. The above improvements correlated well with the improvement of DS findings. It is believed that this procedure should be performed to prevent and improve ischaemic retinopathy caused by ischaemic ICA lesion.