Vargas GJH, Cano MI, Huerta CM, Guardiola FA

Language: Spanish
References: 19
Page: 233-246
PDF size: 435.30 Kb.

ABSTRACT

Introduction. Carotid Doppler ultrasound, which evaluates the extracranial region of the internal carotid artery, does not study its petrous, cavernous, and cerebral segments; those segments should be evaluated by means of more costly, and in some cases invasive, specialized studies such as cerebral angiography, angiotomography, and magnetic angioresonance. Orbital Doppler ultrasound detects changes in frequency reflected by the blood circulating in a blood vessel, allowing quantitative estimation of its rate and direction of flow. The analysis can be performed with the same equipment and by the same personnel who administer carotid Doppler ultrasound. It allows us to evaluate various anomalies in the structures of the eye socket such as cataracts, vitreous degeneration, hemovitreous, and vascular disorders that affect the eye socket such as ocular ischemic syndrome and orbital arteriovenous fistulas.br> Purpose. Corroborate the association, established in prior studies, between alterations of flow in the orbital and carotid blood vessels. Show that added use of orbital and carotid Doppler ultrasound provides better diagnoses in patients with risk factors for obstructive carotid disease and stroke, compared with the present practice of exclusive use of carotid Doppler ultrasound.
Material and method. Orbital and carotid Doppler ultrasounds were taken of 54 patients with risk factors for obstructive carotid disease and stroke, i.e. diabetes mellitus, hypertension, dyslipidemia, and obesity; referred by specialized services and by outpatient service in the departments of internal medicine and ophthalmology at Hospital Metropolitano Dr. Bernardo Sepulveda, a public healthcare institution in Monterrey, Nuevo Leon, Mexico.
Results. The 54 patients evaluated were aged 23 to 88 years, with a mean age of 51.22 years. Group 1 (20 to 39 years) had 10 patients, group 2 (40 to 59 years) 30 patients, and group 3 (60 years and over) 14 patients. Of the study group (n = 54) 32 patients were female (53.7%) and 22 were male (46.3%). Forty patients (72.2%) presented high blood pressure, 17 patients diabetes mellitus (74.1%), 20 patients dyslipidemia (31.5%), and 37% were overweight. In 7 patients (13%) neurological symptoms were identified and in 14 (26%) visual symptoms. In 10 patients (18.5%) alteration of flow in the ophthalmic artery was identified and in 12 (22.2%) alteration of flow in the central retinal artery.
Discussion and conclusions. This study shows that there is a statistically significant association between 50% upper carotid obstruction and alteration of flow in the ophthalmic artery; between diabetes mellitus and of flow in the ophthalmic artery and the central retinal artery; And with the presence of cataracts or hemovitreous. Finally, there is also a relationship between high blood pressure and cataracts.

REFERENCES

1. Tahmasebpour HR, Buckley AR, Cooperberg PI, Fix CH. Sonographic Examination of the Carotid Arteries. Radiographic 2005;25:1561-1575.

2. Grant EG, Benson CB, Alexandrov AV, et al. Society of Radiologist in Ultrasound Consensus Conference. Carotid Artery Stenosis: Gray-scale and Doppler US Diagnosis. Radiology 2003;209:340- 346.

3. Barrinagarrementeria A, Brito FC, Carlos. Enfermedad Vascular Cerebral. Editorial Manual Moderno pp. 23-56; 221-242.

4. Cejas C, Benavidez S, Sanguinetti MM, et al. Ecografía y Doppler Ocular y Orbitario. Ediciones Journal 2004. pp. 35-62;69-76;77-98;99-118;179-209.

5. Lieb WE, Cohen SM, Merton DA, et al. Color Doppler imaging of the eye and orbit: technique and normal anatomy. Arch Ophtalmol 1991;109:527-531.

6. Guthoff RF, Berger RW, Winkler P, et al. Doppler ultrasonography of the ophthalmic and central retinal vessels. Arch Ophtalmol 1991;109:532-536.

7. Erikson SJ, Hendrix LE, Massaro BM, et al. Collor Doppler Flow Imaging of the Normal and Abnormal Orbit. Radiology 1989;173:511-516.

8. Belden CJ, Abbitt PL, Beadles KA, et al. Color Doppler US of the Orbit. Radiographic 1995;15:589-608.

9. Wong AD, Cooperberg PL, Ross WH, Araki DN. Differentiation of Detached Retina and Vitreous Membrane with Color Flow Doppler. Radiology 1991;178:429-431.

10. Cejas C, Benavidez S, Sanguinetti MM, et al. Color Doppler imaging of the orbit in carotid occlusive disease. Rev. Argen radiol 2001;65(2):79-89.

11. Yamamoto T, Mori K, Yasuhara T, et al.Ophthalmic Artery Blood Flow in Patients with Internal Carotid Artery Occlusion. Br J Ophthalmol 2004;88(4):505-508.

12. Costa VP, Kuzniec S, Molnar LJ, et al. Collateral blood supply through the ophthalmic artery: A steal phenomenon analyzed by color Doppler Imaging. Ophthalmol 1998;105(4):689-693.

13. Lieb WE, Flaharty PM, Sergott RC, et al. Color Doppler imaging provides accurate assessment of orbital blood flow in occlusive carotid artery disease. Ophtalmology 1991;98:548-552.

14. Hu HH, Sheng Wy, Yen MY, Lai ST, Teng MM. Color Doppler imaging of orbital arteries for detection of carotid occlusive disease. Stroke 1993;24:1196-1203.

15. Tatemichi TK, Chamorro A, Petty GW, et al. Hemodynamic role of ophthalmic artery collateral in internal carotid artery occlusion. Neurology 1990; 40: 461- 464.

16. Williamson TH, Baxter GM, Dutton GN. Color Doppler velocimetry of the optic nerve head in arterial occlusion. Ophthalmology 1993;100:(3)312-317.

17. Ho AC, Lieb WE, Flaherty PM et al. Color Doppler imaging of the ocular ischemic syndrome. Ophthalmol 1992;99(9):1453- 1462.

18. Petternel PO, Keber DU, Videcnik VI. Carotid arteries in central retinal vessel occlusion as assessed by Doppler ultrasound. Br J Ophthalmol 1989;73:880- 883.

19. Mawn LA, Hedges TR III, Rand W, et al. Orbital Color Doppler Imaging in Carotid Occlusive Disease. Arch Ophthalmol. 1997;115(4):492-496.