Reversed ophthalmic artery flow in patients with acute ischemic stroke and ipsilateral significant extracranial carotid artery stenosis, and its effect in functional outcome

Abstract

Abstract Background Cerebral hemodynamics and collateral circulation have an important role in determining stroke outcome, while the role of primary collateral is well known, the role of secondary collaterals including ophthalmic artery flow is still controversial. Our aim was to evaluate the flow of ophthalmic artery in patients with acute ischemic stroke and significant extracranial carotid stenosis and assess its role on the functional outcome. Thirty patients with acute ischemic stroke and extracranial carotid stenosis were included from Ain Shams University hospitals, color coded duplex was used to assess extracranial carotid arteries, ophthalmic artery was assessed by transcranial color-coded duplex. According to ophthalmic artery flow patients were divided into two groups, one with forward and other with reversed flow. Modified Rankin Scale (MRS) after 3 months was compared between the two groups Results Reversed ophthalmic artery flow (ROAF) was seen among 10 (33.33%) patients. After 3 month MRS was better in ROAF group (1.5 ± 1.958) than forward ophthalmic artery flow (FOAF) group (2.1 ± 1.954) but with no statistical difference (p value 0.398); furthermore, the difference between MRS after 3 months and discharge was significant in ROAF group (p value 0.042). Conclusions Transcranial duplex is a noninvasive, safe method in determining ophthalmic artery flow; furthermore, ROAF could help in better stroke outcome.