Saratov JOURNAL of Medical and Scientific Research

Assess of treatment effectiveness of chronic ocular ischemic syndrome due to internal carotid artery stenosis of varying degrees

Year: 2020, volume 16 Issue: №1 Pages: 308-312
Heading: Ophtalmology Article type: Original article
Authors: Tuzlaev V.V., Egorov V.V., Kravchenko I.Z., Smoliakova G.P.
Organization: S. Fyodorov Eye Microsurgery Federal State Institution, Postgraduate Institute for Public Health Workers

The purpose of the study is to investigate treatment effectiveness for patients with chronic ocular ischemic syndrome (COIS) due to internal carotid artery (ICA) stenosis of varying degrees. Material and Methods. The study involved 15 patients with stage 3 COIS. They were divided into 2 groups according to treatment type: the 1 st group consisted with 7 patients with COIS and hemodynamically significant ICA stenosis, carotid endarterectomy (CE) was performed; the 2nd group consisted of 6 people with COIS and hemodynamically insignificant ICA stenosis, panretinal photocoagulation (PRP) was performed. Results. Monitoring of groups of patients for 1 year after COIS treatment allowed us to determine differentiated approach to treatment of patients depending on the degree of ICA stenosis. Reconstructive surgery at hemodynamically significant ICA stenosis caused positive dynamics in the improvement of blood flow in the ophthalmic artery (OA) by 63.8% relative to initial maximum systolic blood flow velocity, and decreased in the arterial resistivity index by 12.2%. PRP, due to improvement of microcirculation, which led to stabilization or improvement of best corrected visual acuity and COIS stabilization. Conclusion. The study has shown the appropriateness of differentiated approach to treatment of patients with severe degree COIS due to changes of ICA hemodynamics. Using stage-by-stage PRP and CE at COIS, depending on the degree of ICA stenosis, allows stabilization of ischemic process in the retina and delays the pathological metabolism processes aggravated in the ocular metabolism system.

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