[Efficacy of carotid endarterectomy in patients with stenosis of carotid arteries and acute vision impairment].

ABSTRACT

The article deals with comparing efficacy (improved function of the eye) of surgical and conservative treatment of patients presenting with atherosclerotic stenosis of carotid arteries and acute vision disorders. The surgery group (carotid endarterectomy) comprised a total of 49 patients and the conservative-treatment group consisted of 50 subjects. Methods of examination included determining visual acuity (VA), autorefractometry, direct and reverse ophthalmoscopy under the conditions of mydriasis, contactless computed tomography, computer-assisted static perimetry, assessment of the functional state of the optic nerve (ON) with determination of the parameters of the threshold of electric sensitivity and lability of the optic nerve by phosphene, ultrasonographic scanning of ophthalmic arteries and carotid arteries. The terms of examination were as follows at baseline, one months and one year after surgery or conservative treatment. The results (by the groups) were as follows in amaurosis fugas - improvement of VA by 0.1 and more 15 and 0 (p<0.001), disappearance of fits of amaurosis fugas 16 and 3 (p<0.001), widening of the fields of vision 16 and 0 (p<0.001), improvement of the condition of the optic nerve 16 and 0 (p<0.001), maximal increase of systolic blood velocity in the arteries of the eye (Vs) by 30% and 0. In occlusion of the central retinal artery and its branches - improvement of VA by 0.1 and more 8 and 1 (p=0.005), widening of the fields of vision 6 and 2 (p = 0.112), improved condition of the optic nerve 14 and 0 (p<0.001), increase in the Vs 40% and 0. In acute ischaemic neuropathy - improvement of VA by 0.1 and more 9 and 2 (p<0.001), widening of the fields of vision 9 and 3 (p=0.004), improved condition of the optic nerve 11 and 0 (p<0.001), increased Vs 40% and 0. Total - improvement of VA by 0.1 and more 32 and 2 (p<0.001), widening of the fields of vision 31 and 8 (p<0.001), improved condition of the optic nerve 41 and 0 (p<0.001), Vs increase 40% and 0. Carotid endarterectomy effectively improves the functional state of the eye in patients with stenosis of carotid arteries and acute vision impairments.