| Objectives To discuss the effect of carotid endarterectomy(CEA)on ocular morphology and visual function in patients who were suffered with severe internal carotid artery stenosis but without retinal pathology,and to emphatically reveal the change of choroidal thickness.Methods From February 2019 to November 2019,32 patients who were suffered with severe internal carotid artery stenosis on the one side and no or only mild stenosis of the contralateral internal carotid artery without retinal pathology that were treated with carotid endarterectomy(CEA)in the department of vascular surgery of Hebei General Hospital were selected for this study.The rate of internal carotid artery stenosis on the one side 70%~99% of all patients are defined by computed tomography angiography(CTA)or digital subtraction angiography(DSA)or magnetic resonance angiography(MRA)before operated.All patients underwent the examination of transcrsnial doppler(TCD)to measure the peak systolic velocity(PSV)and resistance index(RI)about ophthalmic artery(OA),and to record the spectral morphology of ophthalmic artery one day before the CEA and one week after.Enhanced depth imaging optical coherence tomography(EDI-OCT)was performed to collect the values of the choroidal thickness(subfoveal,1000 ?m nasal and temporal)one day before the CEA,one week and one month after.All patients underwent the examination of the best-corrected visual acuity(BCVA)and visual evoked potential(VEP)before and after CEA.Rebound tonometry was used to measure the intraocular pressure(IOP)during the CEA.Finally,the results are studied statistically.Results The values of ophthalmic artery RI(t=2.144,P<0.05)and LogMAR BCVA(t=3.455,P<0.05)on the operated side before CEA were significantly higher than those of the nonoperated side.Before CEA,there were no significant differences in ophthalmic artery PSV(t=-0.225.P>0.05),choroidal thickness(SFCT t=-0.115,P>0.05;N-CT t=0.448,P>0.05;T-CT t=0.399,P>0.05),latency of VEP(t=0.503,P>0.05)or IOP(t=-0.892,P>0.05)when comparing the operated side to the nonoperated side.On the operated side,Ophthalmic artery PSV significantly increased one week after CEA compared to that before CEA on the operated side(t=7.127,P<0.05),Ophthalmic artery RI significantly reduced one week after CEA compared to that before CEA(t=-6.441,P<0.05).The ophthalmic artery spectrum of the twelve patients among the thirty-two patients returned to normal level.And the spectral morphology of ophthalmic artery was changed in 20 patients(62.5%).SFCT,N-CT and T-CT significantly increased one week after CEA compared to those before CEA on the operated side(SFCT t=8.948,P= 0;N-CT t=5.320,P=0;T-CT t=9.096,P=0),which significantly increased one month after CEA compared to those one week after CEA(SFCT t=3.547,P=0.001;N-CT t=7.016,P=0;T-CT t=7.253,P=0).LogMAR BCVA significantly reduced one week after CEA(t=-4.676,P=0)compared to that before CEA,which significantly reduced one month after CEA(t=-4.910,P=0)compared to that one week after CEA.Latency of VEP was significantly longer one day after CEA(t=6.490,P=0)than that before CEA on the operated side,which was significantly shorter one week after CEA(t=-2.523,P=0.014)than that before CEA.IOP significantly reduced two minutes after endotracheal intubation(t=-8.304,P=0)compared to that before CEA on the operated side,which significantly increased two minutes after CEA(t=3.128,P=0.004)compared to that before CEA.There were no significant differences in IOP at one day after CEA(t=0.733,P=0.469),two days after CEA(t=-0.775,P=0.444)or seven days after CEA(t=5.527,P=0.017)compared to that before CEA.However,IOP significantly increased one month after CEA(t=-8.304,P=0)compared to that before CEA on the operated side.Conclusions 1 CEA could effectively improve the hemdynmics of ophthalmic artery in patients who were suffered with severe internal carotid artery stenosis without retinal pathology,which was greatly to increase the choroidal thickness,and beneficial to improve the vision function.2 EDI-OCT might be considered as an ophthalmic method to evaluate the prognosis of CEA in patients.Figure [3];Table [14];Reference [118]... |
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