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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2003, Número 5

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Rev Mex Oftalmol 2003; 77 (5)


Síndrome ocular isquémico. Correlación con aterosclerosis extracraneal e intracraneal valorada por angio-tomografía

Leroux-Corona GC, Murillo–Bonilla L, Lozano–Elizondo D

Idioma: Español
Referencias bibliográficas: 29
Paginas: 170-175
Archivo PDF: 283.33 Kb.


RESUMEN

Antecedentes: El síndrome ocular isquémico se asocia a aterosclerosis carotídea. Pacientes con infarto cerebral y aterosclerosis carotídea e intracraneal presentan peor pronóstico funcional que pacientes con aterosclerosis carotídea aislada.
Objetivos: Determinar si los pacientes con síndrome ocular isquémico y aterosclerosis carotídea e intracraneal tienen peor pronóstico visual que pacientes con síndrome ocular isquémico y aterosclerosis carotídea aislada.
Pacientes y métodos: Se estudiaron 13 pacientes con aterosclerosis carotidea aislada y 13 pacientes con aterosclerosis carotídea e intracraneal. Se determinó la asociación entre pronóstico visual y la presencia o no de aterosclerosis intracraneal mediante la obtención de razones de momios con sus intervalos de confianza al 95%; se consideró significativo una p=0.05.
Resultados: Predominó el sexo masculino, 69% con aterosclerosis carotídea y 54% con aterosclerosis carotidea e intracraneal, con una edad media de 64 y 68 años respectivamente. No se presentaron diferencias en edad, género y factores de riesgo vascular. En el grupo de aterosclerosis carotídea e intracraneal se presentó asociación con retinopatía mixta RM 2.17 (IC95% 1.20–3.90) (p=0.005), afección visual severa RM 8.80 (IC95% 1.35–57.43) (p=0.016), y afección binocular RM 1.86 (IC95% 1.12–3.07) (p=0.015).
Conclusión: La aterosclerosis intracraneal es un factor determinante en el pronóstico visual de los pacientes con síndrome ocular isquémico.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Costa VP, Kuzniec S, Molnar LJ, Cerri GG, Puech-Leao P, Caravalho CA: Clinical findings and hemodinamic changes associated with severe occlusive carotid artery disease. Ophthalmology 1997;104:1994-2002.

  2. Hedges TR Jr: Ophthalmoscopic findings in internal carotid artery occlusion. Bull Hopkins Hosp 1962;111:89-97.

  3. Dugan JD, Green WR: Ophthalmic manifestations of carotid occlusive disease. Eye 1991;5:226-38.

  4. Virchow R: Zur pathologischen anatomie der netzhaut und des seherven. Arch Pathol Anat Physiol Klin Med 1856; 10:170-193.

  5. MRC European Carotid Surgery Trial: Interium results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery Trialists Collaborative Group. Lancet 1991; 337:1235-1243.

  6. Barnett HJM, Taylor DW, Eliasziw M, Fox AJ, Ferguson G y cols.: Benefit of carotid endarterectomy in patients with symptomatic moderated to severe stenosis. N Engl J Med 1998; 339:1415-1425.

  7. de Jong G, Kessels F, Lodder J: Two types of lacunar infarcts: Further arguments from a study on prognosis. Stroke 2002; 33:2072-2076.

  8. Espinola-Klein C, Rupprecht HJ, Blankenberg S, Bickel C, Peth S, Kopp H, Victor A, Hafner G, Meyer J: Manifestations of atherosclerosis in various vascular regions. Similarities and differences regarding epidemiology, etiology and prognosis. Med Klin 2002; 97:221-228.

  9. Newman AB, Shemanski L, Manolio TA, Cushman M, Mittelmark M, Polak JF, Powe NR, Siscovick D: Ankle-arm index as a predictor of cardiovascular disease and mortality in the Cardiovascular Health Study. The Cardiovascular Health Study Group. Arterioscler Thromb Vasc Biol 1999; 19:538-545.

  10. Culebras A, Kase CS, Masdeu JC, Fox AJ, Bryan RN, Grossman CB, Lee DH: Practice guidelines for the use of imaging in transient ischemic attacks and acute stroke. A report of the stroke council, American Heart Association. Stroke 1997; 28:1480-1497.

  11. Schwartz RB, Jones KM, Chernoff DM, Mukherji SK, Khorasani R, Tice HM, Kikinis R, Hooton SM, Steig PE, Polak JF: Common carotid artery bifurcation: Evaluation with spiral CT. Radiology 1992; 185:513-519.

  12. Anderson GB, Ashforth R, Steinke DE, Ferdinandy R, Findlay JM: CT angiography for the detection and characterization of carotid artery bifurcation disease. Stroke 2000; 31:2168-2174.

  13. Mizener JB, Podhajsky P: Ocular ischemic syndrome. Ophthalmology 1997; 104:859-864.

  14. Nakashima Y, Chen YX, Kinukawa N, Sueishi K: Distributions of diffuse intrimal thickening in human arteries: Preferential expression in atherosclerosis-prone arteries from an early age. Virchows Arch 2002; 441:279-288.

  15. Ross R: The pathogenesis of atherosclerosis: a perspective for the 1990´s. Nature 1993; 362:801-809.

  16. Ramírez JA: Isolation of chlamydia pneumoniae from the coronary artery of a patient with coronary atherosclerosis. Annals Int Med 1996; 125:979-982.

  17. Dormandy J, Heeck K, Vig S: Lower-Extremity arteriosclerosis as a reflection of a systemic process: Implications for concomitant coronary and carotid disease. Semin Vasc Surg 1999; 12:118-122.

  18. Strandberg TE, Pitkala K, Berglind S, Nieminen MS, Tilvis RS: Multifactorial cardiovascular disease prevention in patients aged 75 years and older: A randomized controlled trial: Drugs and Evidence Based Medicine in the Elderly (DATABASE) Study. Am Heart J 2001; 142:945-951.

  19. Lernfelt B, Forsberg M, Blomstrand C, Mellstrom D, Volkmann R: Cerebral atherosclerosis as predictor of stroke and mortality in representative elderly population. Stroke 2002; 33:224-229.

  20. Voller H: Peripheral arterial disease (PAD): Secondary prevention. Dtsch Med Wochenschr 2002; 127:1870-1872.

  21. Burek KA, Sutton-Tyrrell K, Brooks MM, Naydeck B, Keller N, Sellers MA, Roubin G, Jandova R, Rihal CS: Prognostic importance of lower extremity arterial disease in patients undergoing coronary revascularization in the Bypass Angioplasty Revascularization Investigation (BARI). J Am Coll Cardiol 1999; 34:716-721.

  22. Ross RT, Morrow IM: Ocular and cerebral ischaemic mechanism in disease of the internal carotid artery. Can J Neurol Sci 1984; 11:262-268.

  23. Schilder P: Ocular blood flow responses to pathology of the carotid and cerebral circulations. Surv Ophthalmol 1994; 38(Suppl):S52-S58.

  24. Chen KJ, Chen SN, Kao LY, Ho CL, Chen TL, Lay CC, Wu SC: Ocular ischemic syndrome. Chang Gung Med J 2001; 24:483-491.

  25. Brown GC, Magargal LE: The ocular ischemic syndrome. Clinical, fluorescein angiographic and carotid angiographic features. Int Ophthalmol 1988; 11:239-251.

  26. Wong TY, Klein R, Sharrett AR, Couper DJ, Klein BE, Liao DP, Hubbard LD, Mosley TH: Cerebral white matter lesions, retinopathy, and incident clinical stroke. JAMA 2002; 288:67-74.

  27. Sivalingam A, Brown GC, Migargal LE: The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment. Int Ophthalmol 1991; 15:15-20.

  28. Aronow WS, Ahn C: Risk factors for new atherothrombotic brain infarction in older Hispanic men an women. J Gerontol A Biol Sci Med Sci 2002; 57:M61-63.

  29. Sacco RL, Roberts JK, Boden-Albala B, Gu Q, Lin IF, Karfgram DE, Berglund K, Hauser WA, Shea S, Paik MC: Race-ethnicity and determinants of carotid atherosclerosis in a multiethnic population. The Northern Manhattan Stroke Study. Stroke 1997; 28:929-935.




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