Abstract：Objective To analyze the ophthalmological diagnosis and treatment results of carotid artery stenosis patients first diagnosed with ocular symptoms, in order to reduce the missed diagnosis of carotid artery stenosis, improve the prognosis of patients, and improve the quality of life of patients.Methods A total of 19 patients (19 eyes) who were admitted to the Ophthalmology Department of Dalian Municipal Central Hospital from January 2018 to November 2020 due to ocular symptoms and were later diagnosed with carotid artery stenosis were retrospectively selected.All patients underwent routine ophthalmological examination, fundus fluorescent-contrast examination, and color ultrasonography of carotid artery and retrobulbular vessels.The ophthalmological examination, carotid artery stenosis grading, treatment and prognosis of the patients were analyzed.Results There were 15 cases of sudden decline of monocular vision, 2 cases of transient amaurosis, 2 cases of vision loss with eye pain.There were 10 cases of retinal vein occlusion, 2 cases of retinal artery occlusion, 3 cases of ocular ischemic syndrome (including 2 cases with neovascular glaucoma), 2 cases of anterior ischemic optic neuropathy, and 2 cases of transient amaurosis without specific ophthalmic diagnosis.Carotid artery stenosis classification, carotid stenosis was 30%-50% in 2 cases, 51%-70% in 9 cases and 71%-99% in 8 cases.In ophthalmology department, symptomatic treatments such as improving microcirculation and vasodilating were given.Patients with carotid artery stenosis that did not meet the surgical intervention criteria were given oral drugs.After surgical intervention, the visual prognosis was not significantly improved, but fluorescene angiography showed that the arm-retinal circulation time was improved.Conclusion Patients with carotid artery stenosis can be first diagnosed in ophthalmology due to ocular symptoms.Therefore, great attention should be paid to timely screening to avoid missed diagnosis, reduce systemic complications and improve the quality of life of patients.
Gasecki AP，Eliasziw M，Ferguson GG，et al.Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion：results from NASCET.North American Symptomatic Carotid Endarterectomy Trial （NASCET）Group[J].J Neurosurg，1995，83（5）：778-782.
Lee J，Kim SW，Lee SC，et al.Co-occurrence of acute retinal artery occlusion and acute ischemic stroke：diffusion-weighted magnetic resonance imaging study[J].Am J Ophthalmol，2014，157（6）：1231-1238.
[7]
Helenius J，Arsava EM，Goldstein JN，et al.Concurrent acute brain infarcts in patients with monocular visual loss[J].Ann Neurol，2012，72（2）：286-293.
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