Visual outcomes in carotid stenosis patients treated using endarterectomy

Abstract

<br><b>Introduction:</b> Carotid arthrosclerosis can cause visual impairment. It has been observed that carotid endarterectomy has a positive effect on ophthalmic parameters. The aim of this study was to evaluate the impact of endarterectomy on optic nerve functioning.</br> <br><b>Material and methods:</b> A total of 54 asymptomatic patients (19 women and 35 men, 108 eyes) with unilateral carotid stenosis of >70% of the internal carotid artery were recruited to the study. All of them were qualified for endarterectomy. The whole study group underwent Doppler ultrasonography of the internal carotid arteries and ophthalmic examination before the surgery, with 22 of them (11 women and 11 men) being examined after the endarterectomy. The ophthalmic examination included distant best-corrected visual acuity, measurement of intraocular pressure, electrophysiology (pattern visual evoked potentials), perimetry and optical coherent tomography (thickness of the retinal nerve fibre layer).</br> <br><b>Discussion:</b> Carotid arteries supply the brain and face with blood. Extensive research has observed a concomitant improvement in eyesight in patients with artery stenosis after carotid endarterectomy. This effect was associated with better blood flow in the ophthalmic artery and its branches, the central retinal artery and the ciliary artery – the major blood supply of the eye.</br> <br><b>Results:</b> The study proved that carotid endarterectomy has a positive impact on the functioning of the optic nerve. The visual field parameters and amplitude of pattern visual evoked potentials significantly improved. The preoperative and postoperative values of intraocular pressure and of thickness of the retinal nerve fibre layer remained stable.</br>