Abstract
Venous stasis retinopathy and ischemic oculopahy are less familiar ocular manifestations of cerebrovascular disease than amaurosis fugax. When the ischemic changes are limited to the posterior part of the eye, the condition is termed venous stasis retinopathy. If these changes spread and involve the anterior part of the eye, it is called ischemic oculopathy, which is thought to terminate in neovascular glaucoma.
In the present report, brain CTand cerebral angiograms in six male patients with venous stasis retinopathy and/or ischemic oculopathy were studied (age ranging from 41 to 68 with a mean of 56 years old).
Ocular symptoms in these patients were decreased visual acuity and episodes of transinet monocular blindness (amaurosis fugax) : two patients presented with decreased visual acuity alone, three had both decreased visual acuity and amaurosis fugax, and one (had) amaurosis fugax alone.
Brain CT showed subcortical small infarction (s) in four patients and no detectable lesions in the remaining two. In all six patients an occlusion of internal carotid artery ipsilateral to the affected eye was demonstrated in the neck by angiography. A rich collateral circulation to the brain was demonstrated through the ophthalmic artery in all but one patient.
It was suggested that blood supply to the eye ball was stolen because of this rich collateral blood flow to the brain, and that this “ophthalmic artery steal phenomenon” caused the venous stasis retinopathy. As four of six patients later developed neovascular glaucoma, repeated ophthalmologic examinations should regularly be performed in such patients with the internal carotid artery occlusion that have no or small infarctions on CT and good collateral circulation through the opthalmic artery to the brain.
