Himasree Thankamani1, Shaji Ankan2, Sunil Maruthivila Sudhakaran3, Naina Jabeen Hyder4
BACKGROUND
Central retinal artery occlusion (CRAO) was first described by Van Graefe in 1859
as an embolic event to the central retinal artery in a patient with endocarditis.
CRAO has various causes, but patients typically present with sudden, severe, and
painless loss of vision. Retinal arterial occlusions are a cause for profound visual
loss in the population. Carotid atherosclerosis is common in elderly people.
Dyslipidaemia, hypertension, and diabetes mellitus are factors which accelerate
the development of carotid atheromatous plaques. Embolism from the carotid
bifurcation is the most common cause of retinal artery occlusions. In retinal arterial
occlusion carotid arterial occlusion is usually assessed using radiological
techniques. The purpose of this study was to evaluate carotid atherosclerotic
disease in patients with arterial occlusions in the eye and determine the relation
between arterial occlusions in the eye & carotid artery occlusive disease.
METHODS
This retrospective study included patients aged thirty and above, who had come
with symptoms suggestive of arterial occlusions in the eye and carotid doppler was
done. The inclusion criteria included patients diagnosed with the following
conditions CRAO, branch retinal artery occlusion (BRAO), ophthalmic artery
occlusion, anterior ischaemic optic neuropathy (AION) and cilioretinal artery
occlusion. Patients usually present with sudden loss of vision in one eye. After
taking a detailed history, all patients were subjected to a thorough ocular
examination. Patient’s vision is assessed using Snellen’s visual acuity chart,
pupillary assessment done, and fundus examination to look for retinal arterial
occlusion is also done. Fundus imaging is also done. Carotid doppler was done to
rule out carotid artery occlusive disease.
RESULTS
Patients presenting with retinal arterial occlusion should be investigated
thoroughly for both systemic and local causes of CRAO. The risk of developing
arterial occlusions were 1.7 - 9.15 times more in patients with carotid artery
occlusion than in patients with normal carotids. Arterial occlusion was more found
in patients with 70 % occlusion of the carotid artery.
CONCLUSIONS
There was a strong association between retinal arterial occlusions and carotid
artery occlusion.
