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Ehrnrooths Stiftelse","doi-asserted-by":"publisher","award":["202000028"],"award-info":[{"award-number":["202000028"]}],"id":[{"id":"10.13039\/100015738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We describe hypoperfusion\u2010related and embolic ocular signs of carotid stenosis (CS) before and six months after carotid endarterectomy (CEA) in a CS population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled prospectively 70 CEA patients (81% male, mean age 69) and 41 non\u2010medicated control subjects (76%, 68), from March 2015 to December 2018, assessing intraocular pressure (IOP), best\u2010corrected visual acuity (BCVA) in logMAR units and performing a bio\u2010microscopy examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Main index symptoms included amaurosis fugax (Afx) (29, 41%) and hemispheric TIA (17, 24%), and 17 (24%) were asymptomatic. Of the 70, 17 patients (24%, 95% CI 16\u201036) showed ocular signs of CS. Of four embolic (Hollenhorst plaques) findings, one small macular plaque disappeared postoperatively. Four had hypoperfusion, that is ocular ischaemic syndrome (OIS), requiring panretinal photocoagulation: one for multiple mid\u2010peripheral haemorrhages, two for iris neovascularization and one for neovascular glaucoma (NVG); only the NVG proved irreversible. Nine (<jats:italic>de novo<\/jats:italic> in three) showed mild OIS, <jats:italic>that is<\/jats:italic> only few mid\u2010peripheral haemorrhages, ranging pre\u2010 \/postoperatively in ipsilateral eyes from one to eleven (median two)\/ one to two (median one), and in contralateral eyes from three to nine (median five)\/ one to six (median three). Pre\u2010 and postoperative median BCVA was 0 or better, and mean IOP was normal, except in the NVG patient. Temporary visual impairment from 0 to 0.3 occurred in one eye soon after CEA due to ocular hyperperfusion causing macular oedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ocular signs of CS are common in CEA patients, ranging from few mid\u2010peripheral haemorrhages to irreversible NVG. Clinicians should be aware of these signs in detecting CS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.15019","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T17:41:39Z","timestamp":1634233299000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ocular signs of carotid stenosis in ipsi\u2010 and contralateral eyes before and after carotid endarterectomy: a prospective study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7871-5493","authenticated-orcid":false,"given":"Marianne","family":"Ala\u2010Kauhaluoma","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista","family":"Nuotio","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Ij\u00e4s","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suvi Maaria","family":"Koskinen","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Radiology HUS Diagnostic Center University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pirkka","family":"Vikatmaa","sequence":"additional","affiliation":[{"name":"Department of Vascular surgery University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heli","family":"Silvennoinen","sequence":"additional","affiliation":[{"name":"Department of Radiology HUS Diagnostic Center University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristiina","family":"Relander","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perttu J.","family":"Lindsberg","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauri","family":"Soinne","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0028-5056","authenticated-orcid":false,"given":"Paula A.","family":"Summanen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14648"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfo.2017.12.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)75767-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.03.054"},{"key":"e_1_2_8_7_1","first-page":"519","article-title":"The Ocular ischemic syndrome","volume":"21","author":"Brown GC","year":"2007","journal-title":"Berlin; New York. 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