Retinal ganglion cell complex and peripapillary retinal nerve fiber layer thicknesses following carotid endarterectomy
- 80 Downloads
To examine changes in retinal ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses by optical coherence tomography (OCT) in contralateral and ipsilatateral eyes of carotid artery stenosis (CAS) patients before and after carotid endarterectomy (CEA).
Forty-two consecutive patients diagnosed with CAS (70–99% stenosis rate) who underwent CEA were included in this prospective cross-sectional study. The indication for CEA was based on the Asymptomatic Carotid Atherosclerosis Study. Doppler ultrasonography and computed tomography angiography were performed to calculate CAS. All the subjects underwent an ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP) measurements, biomicroscopy, fundoscopy, and OCT before and after the surgery.
The mean preoperative intraocular pressure was 15.2 ± 2.1 mmHg in the ipsilateral eye and 15.8 ± 2.7 in the contralateral eye. The mean postoperative intraocular pressure in the ipsilateral and contralateral eye was 18.6 ± 3.0 and 19.3 ± 3.8, respectively. The intraocular pressure was significantly higher in postoperative eyes (p = 0.0001). There was a statistically significant decrease in peripapillary RNFL thickness in superior quadrants postoperatively in ipsilateral eyes. The retinal GCC layer thickness was not significantly different before and after CEA in ipsilateral and contralateral eyes.
Carotid endarterectomy results in thinning of the superior peripapillary RNFL thickness. To the best of our knowledge, this is the first study to examine peripapillary RNFL and GCC thicknesses before and after CEA.
KeywordsCarotid endarterectomy Ganglion cell complex Retinal nerve fiber layer
- 1.Shii M, Hayashi M, Yagi F, Sato K, Tomita G, Iwabuchi S (2016) Relationship between the direction of ophthalmic artery blood flow and ocular microcirculation before and after carotid artery stenting. J Ophthalmol 2016:2530914. https://doi.org/10.1155/2016/2530914 (Epub 2016 Dec 14) CrossRefGoogle Scholar
- 19.Keunen RW, Eikelboom BC, Stegeman DF, Ackerstaff RG (1994) Chronic cerebral hypotension induces a downward shift of the cerebral autoregulation: a hypothesis based on TCD and OPG-GEE studies in ambulatory patients with occlusive cerebrovascular disease. Neurol Res 16(6):413–416CrossRefPubMedGoogle Scholar
- 23.Kragsterman B, Bergqvist D, Siegbahn A, Parsson H (2017) Carotid endarterectomy induces the release of inflammatory markers and the activation of coagulation as measured in the jugular bulb. J Stroke Cerebrovasc Dis. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.05.020 (Epub ahead of print) PubMedCrossRefGoogle Scholar
- 26.Wang J, Wang W, Jin B et al (2016) Improvement in cerebral and ocular hemodynamics early after carotid endarterectomy in patients of severe carotid artery stenosis with or without contralateral carotid occlusion. Biomed Res Int 2016:2901028. https://doi.org/10.1155/2016/2901028 PubMedPubMedCentralCrossRefGoogle Scholar
- 35.Gonul S, Koktekir BE, Bakbak B, Gedik S (2013) Comparison of the ganglion cell complex and retinal nerve fibre layer measurements using Fourier domain optical coherence tomography to detect ganglion cell loss in non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol 97(8):1045–1050CrossRefPubMedGoogle Scholar
- 38.Lee JH, Choi CG, Kim DK, Kim GE, Lee HK, Suh DC (2004) Relationship between circle of Willis morphology on 3D time-of-flight MR angiograms and transient ischemia during vascular clamping of the internal carotid artery during carotid endarterectomy. AJNR Am J Neuroradiol 25:558–564PubMedGoogle Scholar
- 44.Lagrèze WA, Knörle R, Bach M, Feuerstein TJ (1998) Memantine is neuroprotective in a rat model of pressure-induced retinal ischemia. Investig Ophthalmol Vis Sci 39(6):1063–1066Google Scholar
- 47.Lam TT, Abler AS, Kwong JM, Tso MO (1999) N-methyl-d-aspartate (NMDA)–induced apoptosis in rat retina. Investig Ophthalmol Vis Sci 40(10):2391–2397Google Scholar
- 56.Novitzky I, Marianayagam NJ, Weiss S, Muhsinoglu O, Fridman M, Leibovitch TA, Goldenberg-Cohen N, Michowiz S (2016) Comparison of neuroprotective effect of bevacizumab and sildenafil following induction of stroke in a mouse model. Biomed Res Int 2016:3938523. https://doi.org/10.1155/2016/3938523 (Epub 2016 May 29) CrossRefPubMedPubMedCentralGoogle Scholar