G Nelles1. 1. -, Werthmannstr. 1c, 50935, Köln, Deutschland, gereon.nelles@uni-due.de.
Abstract
BACKGROUND: Vascular diseases of the eye are common and may be indicative of cerebrovascular diseases. OBJECTIVE: The aim was to describe the significance of neurological evaluation in patients with vascular diseases of the eye. METHODS: A selective literature research using PubMed was performed taking personal experiences as well as recommendations of international and national guidelines into consideration. RESULTS: Patients with transient blindness (amaurosis fugax) have a 4-fold higher risk of stroke during the year following onset of optical symptoms. These patients should be treated with platelet antiaggregants, such as 100 mg/day acetylsalicylic acid (ASS). Patients with > 70 % stenosis of the ipsilateral internal carotid artery should be evaluated for carotid endarterectomy. Colloidal solutions should not be used in patients with cerebrovascular diseases. Avoiding nocturnal blood pressure drop may help to prevent anterior ischemic optical neuropathy in patients with carotid artery disease. Patients with ocular ischemic syndrome often have severe stenosis or occlusion of the internal carotid artery. Duplex ultrasound is the most important diagnostic test. CONCLUSION: Vascular diseases of the eye are frequently associated with cerebrovascular disease. A comprehensive vascular evaluation can contribute to prevention of stroke.
BACKGROUND:Vascular diseases of the eye are common and may be indicative of cerebrovascular diseases. OBJECTIVE: The aim was to describe the significance of neurological evaluation in patients with vascular diseases of the eye. METHODS: A selective literature research using PubMed was performed taking personal experiences as well as recommendations of international and national guidelines into consideration. RESULTS:Patients with transient blindness (amaurosis fugax) have a 4-fold higher risk of stroke during the year following onset of optical symptoms. These patients should be treated with platelet antiaggregants, such as 100 mg/day acetylsalicylic acid (ASS). Patients with > 70 % stenosis of the ipsilateral internal carotid artery should be evaluated for carotid endarterectomy. Colloidal solutions should not be used in patients with cerebrovascular diseases. Avoiding nocturnal blood pressure drop may help to prevent anterior ischemic optical neuropathy in patients with carotid artery disease. Patients with ocular ischemic syndrome often have severe stenosis or occlusion of the internal carotid artery. Duplex ultrasound is the most important diagnostic test. CONCLUSION:Vascular diseases of the eye are frequently associated with cerebrovascular disease. A comprehensive vascular evaluation can contribute to prevention of stroke.
Authors: Anders Perner; Nicolai Haase; Anne B Guttormsen; Jyrki Tenhunen; Gudmundur Klemenzson; Anders Åneman; Kristian R Madsen; Morten H Møller; Jeanie M Elkjær; Lone M Poulsen; Asger Bendtsen; Robert Winding; Morten Steensen; Pawel Berezowicz; Peter Søe-Jensen; Morten Bestle; Kristian Strand; Jørgen Wiis; Jonathan O White; Klaus J Thornberg; Lars Quist; Jonas Nielsen; Lasse H Andersen; Lars B Holst; Katrin Thormar; Anne-Lene Kjældgaard; Maria L Fabritius; Frederik Mondrup; Frank C Pott; Thea P Møller; Per Winkel; Jørn Wetterslev Journal: N Engl J Med Date: 2012-06-27 Impact factor: 91.245
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