Advertisement

A Review of the Carotid Artery Stenosis and Ocular Ischemic Disease from the Perspective of Integrative Medicine

  • Ran Sun
  • Dachuan Liu
  • Qi Zhou
Chapter
Part of the Advances in Visual Science and Eye Diseases book series (AVSED, volume 3)

Abstract

The carotid artery is the main blood vessel linking the heart, head, and face. Carotid artery stenosis is one of the most common causes of ischemic stroke. Ocular ischemic diseases are a group of diseases where pathophysiological changes are caused by ischemia of eye tissues. Many patients with carotid artery stenosis show symptoms of ocular ischemic diseases first and visit the ophthalmology department; no matter transient or persistence, patients with carotid stenosis who have ocular symptoms often have severe carotid artery stenosis already. From the perspective of ophthalmology, even though the etiology of ischemic ophthalmopathy is complex, they can all lead to pathological changes of retinal nerve tissues and vascular tissue. This makes early diagnosis difficult, and often requires repeated surgical treatments to rescue the remnant visual function in the advanced stage. From the perspective of integrative medicine, the anatomical homology of the carotid artery and ophthalmic artery determines their inseparable relationship; ocular ischemic disease is essentially a blood circulation disorder disease. We should look beyond the organs when analyzing it, and in the analysis of ocular blood circulation we should not only consider the terminal blood supply like the central retinal artery but also figure out the condition of the carotid artery. On the other hand, if we are studying the ocular ischemic syndrome in the view of integrative medicine, we will find that the essence is the decrease of blood supply from upstream vessels of ocular artery, i.e., the carotid artery. This will lead to a chronic or acute ischemia, not only the fundus but also the whole eye globe. Therefore, when considering treatment, we should jump out of the mindset of sub-disciplines and solve the fundamental problem. Other symptoms will also be easily solved in this way.

References

  1. 1.
    Li XP, Zhang B. Relationship of cerebral infarction with carotid atherosclerosis and blood-lipid. J Mod Med. 2004;14(21):137–8.Google Scholar
  2. 2.
    Hendrikse J, Hartkamp MJ, Hillen B, et al. Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion: border gone infarcts and clinical symptoms. Stroke. 2002;32(12):2768–73.CrossRefGoogle Scholar
  3. 3.
    Telman G, Kouperberg E, Spreeher E, et al. Assessment of ophthalmic artery collateral path way in the hemispheric cerebral hemodynamics in patients with severe unilateral carotid stenosis. Neurol Res. 2003;25(3):309–11.CrossRefPubMedGoogle Scholar
  4. 4.
    Ge J, Zhao JL, Cui H. Ophthalmology. Beijing: People’s Medical Publishing House; 2005. p. 88–93.Google Scholar
  5. 5.
    Hsu HY, Yang FY, Chao AC, et al. Distribution of carotid arterial lesions in Chinese patients with transient monocular blindness. Stroke. 2006;37(2):531–2.CrossRefPubMedGoogle Scholar
  6. 6.
    Dhonge M, De Laey JJ. The ocular ischemic syndrome. Bull Soc Belge Ophthalmol. 1989;231:1–13.Google Scholar
  7. 7.
    Holdswomh R, MeCollum PT, Bryce JS, et al. Symptoms, stenosis and carotid plaque morphology. Vasc Endovasc Surg. 1995;9(1):80–5.CrossRefGoogle Scholar
  8. 8.
    Kobayashi S, Hollenhorst RW, Sundt TM Jr. Retinal arterial pressure before and after surgery for carotid artery stenosis. Stroke. 1971;2:569–75.CrossRefPubMedGoogle Scholar
  9. 9.
    Jacobs NA, Trew DR. Occlusion of the central retinal artery and ocular neovascularisation: an indirect association? Eye (Lond). 1992;6(6):599–602.CrossRefGoogle Scholar
  10. 10.
    Huang SM, Xiong X, Tong YY, et al. Color Doppler in detection of blood flow of the ophthalmic artery in patients with carotid atherosclerosis. Chin J Ocular Fundus Dis. 2001;17(2):150–1.Google Scholar
  11. 11.
    Marx JL, Hreib K, Choi TS. Percutaneous carotid artery angioplasty and stenting for ocular ischemic syndrome. Ophthalmology. 2004;111(12):2284–91.CrossRefPubMedGoogle Scholar
  12. 12.
    Ishikawa K, Kimura I, Shinoda K, et al. In situ confirmation of retinal b1ood flow improvement after carotid endarterectomy in a patient with ocular ischemic syndrome. Am J Ophthalmol. 2002;134(2):295–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Ho TY, Lin PK, Huang CH. White centered retinal hemorrhage in ocular ischemic syndrome resolved after carotid artery stenting. J Chin Med Assoc. 2008;71:270–2.CrossRefPubMedGoogle Scholar
  14. 14.
    Rennie CA, Flanagan DW. Resolution of proliferative venous stasis retinopathy after carotid endarterectomy. Br J Ophthalmol. 2002;86:117–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Rose L, Zamir E. Reversite anterior segment ischaemia after carotid endarterectomy. Clin Exp Ophthalmol. 2007;35:94–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Lawrence PF, Oderich GS. Ophthalmologic findings as predictors of carotid artery disease. Vasc Endovascular Surg. 2002;36(6):415–24.CrossRefPubMedGoogle Scholar
  17. 17.
    Alizai AM, Trobe JD, Thompson BG, et al. Ocular ischemic syndrome after occlusion of both external carotid arteries. J Neuroophthalmol. 2005;25:268–72.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Chen KJ, Chen SN, Kao LY. Ocular ischemic syndrome. Chang Gung Med J. 2001;24(8):483–91.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Munch IC, Larsen M. [The ocular ischemic syndrome]. Ugeskr Laeger. 2005;167:3269–73.Google Scholar
  20. 20.
    Kawaguchi S, Sakaki T, Iwahashi H, et al. Effect of carotid artery stenting on ocular circulation and chronic ocular ischemic syndrome. Cerebrovasc Dis. 2006;22:402–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Tang WQ, Wei SH, Li S, et al. A clinical analysis of the ocular manifestations associated with carotid stenosis. Chin J Ocular Fundus Dis. 2006;22(6):376–8.Google Scholar
  22. 22.
    Foncea Beti N, Mateo I, Diaz La Calle V, et al. The ocular ischemic syndrome. Clin Neurol Neurosurg. 2003;106:60–2.PubMedGoogle Scholar
  23. 23.
    Bigou MA, Bettembourg O, Hebert T, et al. Unilateral ocular ischemic syndrome in a diabetic patient. J Fr Ophthalmol. 2006;29:e2.CrossRefGoogle Scholar
  24. 24.
    Chen CS, Miller NR. Ocular ischemic syndrome: review of clinical presentations, etiology, investigation, and management. Compr Ophthalmol Updat. 2007;8:17–28.Google Scholar
  25. 25.
    Welch HJ, Murphy MC, Raftery KB, et al. Carotid duplex with contralateral disease: the influence of vertebral artery blood flow. Ann Vasc Surg. 2000;14:82–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Klijn CJ, Kappelle LJ, van Schooneveld MJ, et al. Venous stasis retinopathy in symptomatic carotid artery occlusion: prevalence, cause, and outcome. Stroke. 2002;33:695–701.CrossRefPubMedGoogle Scholar
  27. 27.
    Wang YL, Zhao L, Li M. Improved circulation in ocular ischemic syndrome after carotid artery stenting. Chin Med J. 2011;124(21):3598–600.PubMedGoogle Scholar
  28. 28.
    Costa VP, Kuzniec S, Molnar U, et al. The effects of carotid endarterectomy on the retrobulbar circulation of patients with severe occlusive carotid artery disease: an investigation by color Doppler imaging. Ophthalmology. 1999;106:306–10.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Kawaguchi S, Okuno S, Sakaki T, et al. Effect of carotid endarterectomy on chronic ocular ischemic syndrome due to internal carotid artery stenosis. Neurosurgery. 2001;48:328–33.PubMedGoogle Scholar
  30. 30.
    Kozobolis VP, Detorakis ET, Georgiadis GS, et al. Perimetric and retrobulbar blood flow changes following carotid endarterectomy. Graefes Arch Clin Exp Opthalmol. 1957;43(4 part 1):583–9.Google Scholar
  31. 31.
    Sivalingam A, Brown GC, Magargal LE. The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment. Int Ophthalmol. 1989;15(1):15–20.CrossRefGoogle Scholar
  32. 32.
    Mizener JB, Podhajsky P, Hayreh SS. Ocular ischemic syndrome. Ophthalmology. 1997;104(5):859–86.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Nussbaumer-Ochsner Y, Eberli FR, Baumgartner RW, et al. Sirolimus-eluting stenting of the external carotid artery for the treatment of ocular ischemia. J Endovasc Ther. 2006;13(5):672–5.CrossRefPubMedGoogle Scholar
  34. 34.
    Onizuka M, Masuya N, Miyazaki H. [Placement of stent for internal carotid artery stenosis in the cervical portion improved ocular ischemic syndrome]. No To shinkei. 2001;53(7):679–82.Google Scholar
  35. 35.
    Luo RJ, Liu SR, Li XM, et al. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis. Chin Med J (Engl). 2010;123(19):2662–5.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and People's Medical Publishing House, PR of China 2020

Authors and Affiliations

  • Ran Sun
    • 1
  • Dachuan Liu
    • 1
  • Qi Zhou
    • 2
  1. 1.Department of OphthalmologyXuanwu Hospital, Capital Medical UniversityBeijingChina
  2. 2.Department of OphthalmologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Personalised recommendations