Ultrasonographic screening of carotid artery in patients with vascular retinopathies.

BACKGROUND AND PURPOSE: Retinal vasculopathy is commonly found with complaint of burred vision by ophthalmologist and closely related to asymptomatic cerebrovascular disease. The purpose of this study was to evaluate patients with microvascular retinopathy by ultrasound sonography of neck carotid artery and to find high risk group for stroke at outpatient of ophthalmology with associated retinopathy.

METHODS

Between 1999 and 2001, a total of 480 consecutive patients visited at outpatient of ophthalmology with a complaint of burred vision were evaluated by ultrasound sonography of neck carotid artery. The patients were divided to with retinopathy (n=253) and without retinopathy (n=227). The former was subgrouped as follows; central retinal vein occlusion (CRVO; n=11), branch of retinal vein occlusion (BRVO; n=71), retinal artery occlusion (RAO; n=8), hypertensive retinopathy group-I (according to Keith, Wagener and Barker's criteria) (HTN-R I; n=43) and group-II (HTN-R II; n=42), and diabetic retinopathy (DM-R; n=78). The latter group was with various ophthalmological diseases, mainly inflammation of cornea, with healthy retinal vessels and constituted as the control group.

RESULTS

There was no statistically significant difference between patients with retinopathy and the control group with respect to sex distribution, nor among the retinopathy groups. Patients with retinopathy had a mean age of 68 years, while those with HTN-R I and II were older with a mean age of 71 years. By ultrasonography, RAO showed pathology in intima-media thickness (IMT; 1.13 +/- 0.55 vs. 0.81 +/- 0.26 mm in control), average number of plaques (1.88 +/- 0.99), degree of stenosis of internal carotid artery (42.4 +/- 28.5%) and common carotid artery (27.4 +/- 21.3%). Those with DM-R had the second thickest IMT (0.96 +/- 0.42 mm) and the second highest quantity of plaque (1.23 +/-1.23), and the second most stenotic common carotid artery (13.1 +/- 17.28%).

CONCLUSION

Moderate sclerotic changes are found in ophthalmology patients with RAO and DM-R, although the degree pathology do not indicate medical nor surgical prophylactic treatment. Retinal vein occlusion, that has been discussed with diminished retinal blood circulation, does not show any differences in comparison with control group and ultra sonography has less value for screening of asymptomatic carotid atherosclerosis.