{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:06:29Z","timestamp":1771927589292,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study was conducted to emphasize the significance of early detection of ocular ischemic syndrome (OIS), indicating advanced carotid atherosclerotic occlusive disease and preceding life-threatening ischemic cerebrovascular events, and to boost education in eyesight care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was performed using PubMed and Embase databases using the keywords \u201ccarotid disease,\u201d \u201cocular ischemic syndrome,\u201d \u201camaurosis fugax,\u201d \u201cearly detection,\u201d and education, selecting 45 articles containing relevant information for our focused review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>OIS is a sight-threatening condition caused by ocular hypoperfusion, secondary to occlusive disease of the common or internal carotid arteries. We observed that this condition can be associated with multiple clinical manifestations, such as progressive or acute visual loss, orbital pain, and iris neovascularization. Carotid artery disease is frequently underdiagnosed due to an unfocused clinical examination of the eye fundus, the presence of carotid bruit, and other similarities associated with ocular ischemic syndrome, while the management of this condition should always be carried out with a multidisciplinary approach by implementing techniques such as panretinal photocoagulation (PRP), the use of ophthalmologic drugs, and surgical management of carotid via endarterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among clinicians, OIS is frequently undetected because the range of symptoms initially exhibited by an individual can mimic age-related visual decline, delaying detection until serious complications such as amaurosis fugax or stroke occur. Proficient skills in fundus examination and carotid artery auscultation are crucial in identifying this harmful condition, including the use of non-invasive procedures and full recognition of the need for early eye care education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2026.1717841","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:22:21Z","timestamp":1769577741000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ocular ischemic syndrome secondary to carotid artery disease: a comprehensive review addressing critical early detection, management, and education"],"prefix":"10.3389","volume":"6","author":[{"given":"Eduardo","family":"\u00c1vila-Figueroa","sequence":"first","affiliation":[{"name":"Facultad Mexicana de Medicina, Universidad La Salle","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Flores-Calvo","sequence":"additional","affiliation":[{"name":"Facultad Mexicana de Medicina, Universidad La Salle","place":["Mexico City, Mexico"]},{"name":"ENT Department, Instituto Nacional de Rehabilitaci\u00f3n Luis Guillermo Ibarra Ibarra","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher C.","family":"S\u00e1nchez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital \u00c1ngeles del Pedregal","place":["Mexico City, Mexico"]},{"name":"Cardiology Department, Instituto Nacional de Cardiolog\u00eda Ignacio Chavez","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irving A.","family":"Dom\u00ednguez-Varela","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Asociaci\u00f3n Para Evitar la Ceguera (APEC), Hospital de la Ceguera","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Salazar-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de San Luis Potos\u00ed","place":["San Luis Potos\u00ed, Mexico"]},{"name":"Community Health and Epidemiology, University of Saskatchewan","place":["Saskatoon, SK, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Zamora Cortina","sequence":"additional","affiliation":[{"name":"Facultad Mexicana de Medicina, Universidad La Salle","place":["Mexico City, Mexico"]},{"name":"Department of Ophthalmology, Asociaci\u00f3n Para Evitar la Ceguera (APEC), Hospital de la Ceguera","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix E.","family":"Tena-Betancourt","sequence":"additional","affiliation":[{"name":"Facultad Mexicana de Medicina, Universidad La Salle","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier E.","family":"Anaya-Ayala","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubiran","place":["Mexico City, Mexico"]},{"name":"Direcci\u00f3n M\u00e9dica Hospital \u00c1ngeles Universidad","place":["Mexico City, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(63)90382-9","article-title":"Ophthalmoscopic findings in internal carotid artery occlusion","volume":"55","author":"Hedges","year":"1963","journal-title":"Am J Ophthalmol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.12659\/msm.883260","article-title":"Ocular ischemic syndrome \u2013 a systematic review","volume":"18","author":"Terelak-Borys","year":"2012","journal-title":"Med Sci Monit"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwab154","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.echo.2007.11.011","article-title":"Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine","volume":"21","author":"Stein","year":"2008","journal-title":"J Am Soc Echocardiogr"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.survophthal.2009.02.024","article-title":"Ocular ischemic syndrome","volume":"55","author":"Mendrinos","year":"2010","journal-title":"Surv Ophthalmol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e3181fe540b","article-title":"Ocular manifestations of Takayasu arteritis: a cross-sectional study","volume":"31","author":"Peter","year":"2011","journal-title":"Retina"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1159\/000235726","article-title":"Acute vision loss after intravitreal injection of bevacizumab (Avastin) associated with ocular ischemic syndrome","volume":"224","author":"Huang","year":"2010","journal-title":"Ophthalmologica"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(25)00635-4","article-title":"Venous-stasis retinopathy of occlusive disease of the carotid artery","volume":"38","author":"Kearns","year":"1963","journal-title":"Proc Staff Meet Mayo Clin"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23095249","article-title":"Ocular ischemic syndrome and its related experimental models","volume":"23","author":"Lee","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/BF00131023","article-title":"The ocular ischemic syndrome: clinical, fluorescein angiographic and carotid angiographic features","volume":"11","author":"Brown","year":"1988","journal-title":"Int Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/11206721231199516","article-title":"A case of ocular ischemic syndrome in spontaneous acute internal carotid dissection: the importance of multidisciplinary management","volume":"34","author":"Cattaneo","year":"2024","journal-title":"Eur J Ophthalmol"},{"key":"B12","article-title":"Ocular ischemic syndrome","volume-title":"StatPearls","author":"Sood","year":"2021"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1177\/153857440203600602","article-title":"Ophthalmologic findings as predictors of carotid artery disease","volume":"36","author":"Lawrence","year":"2002","journal-title":"Vasc Endovasc Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/BF00150974","article-title":"The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment","volume":"15","author":"Sivalingam","year":"1991","journal-title":"Int Ophthalmol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520420037035","article-title":"Executive\u00a0Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis","volume":"273","author":"Walker","year":"1995","journal-title":"JAMA"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30117-0","article-title":"Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modeling study","volume":"8","author":"Song","year":"2020","journal-title":"Lancet Glob Health"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.68.10.716","article-title":"Chronic ocular ischemia","volume":"68","author":"Sturrock","year":"1984","journal-title":"Br J Ophthalmol"},{"key":"B18","article-title":"The ocular aspects of carotid bypass surgery","volume":"76","author":"Kearns","year":"1978","journal-title":"Trans Am Ophthalmol Soc"},{"key":"B19","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1161\/hs0302.104619","article-title":"Venous stasis retinopathy in symptomatic carotid artery occlusion: prevalence, cause, and outcome","volume":"33","author":"Klijn","year":"2002","journal-title":"Stroke"},{"key":"B20","article-title":"Branch retinal-artery obstruction: a review of 201 eyes","volume":"21","author":"Ros","year":"1989","journal-title":"Ann Ophthalmol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"443","DOI":"10.4103\/ijo.IJO_1769_21","article-title":"Fundus autofluorescence in detection of embolus in retinal artery occlusion","volume":"2","author":"Sagar","year":"2022","journal-title":"Indian J Ophthalmol Case Rep"},{"key":"B22","doi-asserted-by":"crossref","DOI":"10.1016\/B978-0-323-02598-0.50090-2","volume-title":"Ocular ischemic syndrome","author":"Sharma","year":"2006"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.311098","article-title":"Reassessing the mechanisms of\u00a0acute\u00a0coronary syndromes","volume":"124","author":"Libby","year":"2019","journal-title":"Circ Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1216063","article-title":"Mechanisms of acute coronary syndromes and their implications for therapy","volume":"368","author":"Libby","year":"2013","journal-title":"N Engl J Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.040","article-title":"Endogenous fibrinolysis: an important mediator of thrombus formation and cardiovascular risk","volume":"65","author":"Okafor","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2021.02.006","article-title":"Inpatient ophthalmology consultations","volume":"105","author":"Grewal","year":"2021","journal-title":"Med Clin North Am"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/s0161-6420(97)30221-8","article-title":"Ocular ischemic syndrome","volume":"104","author":"Mizener","year":"1997","journal-title":"Ophthalmology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.1989.tb01620.x","article-title":"Chronic ocular ischaemia","volume":"67","author":"Kerty","year":"1989","journal-title":"Acta Ophthalmol"},{"key":"B29","article-title":"The funduscopic examination","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations","author":"Schneiderman","year":"1990"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.4103\/0301-4738.77013","article-title":"Visual fields in neuro-ophthalmology","volume":"59","author":"Kedar","year":"2011","journal-title":"Indian J Ophthalmol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(86)90071-1","article-title":"Macular edema in association with severe carotid artery obstruction","volume":"102","author":"Brown","year":"1986","journal-title":"Am J Ophthalmol"},{"key":"B32","article-title":"Screening for asymptomatic carotid stenosis: a systematic review and meta-analysis for the US Preventive Taskforce","author":"Jonas","year":"2014"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.04.011","article-title":"European society for vascular surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease","author":"Naylor","year":"2023","journal-title":"Eur J Vasc Endovascular Surg"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2008.10.015","article-title":"Joint recommendations for reporting carotid ultrasound investigations in the United Kingdom","volume":"37","author":"Oates","year":"2009","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1979.00500470045007","article-title":"Unilateral visual loss in bright light: an unusual symptom of carotid artery occlusive disease","volume":"36","author":"Furlan","year":"1979","journal-title":"Arch Neurol"},{"key":"B36","article-title":"Panretinal photocoagulation for progressive ocular neovascularization secondary to occlusion of the common carotid artery","volume":"16","author":"Carter","year":"1984","journal-title":"Ann Ophthalmol"},{"key":"B37","article-title":"Successful treatment of the ocular ischemic syndrome with panretinal photocoagulation and cerebrovascular surgery","volume":"23","author":"Johnston","year":"1988","journal-title":"Can J Ophthalmol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.30.9.1751","article-title":"The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients","volume":"30","author":"Ferguson","year":"1999","journal-title":"Stroke"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)90086-6","article-title":"The effects of carotid endarterectomy on the retrobulbar circulation of patients with severe occlusive carotid artery disease: an investigation by color Doppler imaging","volume":"106","author":"Costa","year":"1999","journal-title":"Ophthalmology"},{"key":"B40","article-title":"Increased intraocular pressure following endarterectomy","volume":"19","author":"Melamed","year":"1987","journal-title":"Ann Ophthalmol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/350475","article-title":"Ocular circulation and chronic ocular ischemic syndrome before and after carotid artery revascularization surgery","volume":"2012","author":"Kawaguchi","year":"2012","journal-title":"J Ophthalmol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.12.098","article-title":"Ocular ischemic syndrome and the role of carotid artery revascularization","volume":"105","author":"Suhail","year":"2024","journal-title":"Ann Vasc Surg"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.071","article-title":"In vivo diagnosis of plaque erosion and calcified nodule in patients with acute coronary syndrome by intravascular optical coherence tomography","volume":"62","author":"Jia","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"210.e216","DOI":"10.1016\/j.ejvs.2022.04.013","article-title":"Validation of a standardised duplex ultrasound classification system for the reporting and grading of peripheral arterial disease","volume":"64","author":"Huthart","year":"2022","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.722355","article-title":"Smooth muscle cells healing\u00a0atherosclerotic plaque disruptions are of local, not blood, origin in apolipoprotein E knockout mice","volume":"116","author":"Bentzon","year":"2007","journal-title":"Circulation"},{"key":"B46","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1053\/ejvs.1999.0951","article-title":"Internal carotid artery stenosis: rate of progression","volume":"19","author":"Liapis","year":"2000","journal-title":"Eur J Vasc Endovascular Surg"}],"container-title":["Frontiers in Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1717841\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:13:54Z","timestamp":1771924434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1717841\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":46,"alternative-id":["10.3389\/fopht.2026.1717841"],"URL":"https:\/\/doi.org\/10.3389\/fopht.2026.1717841","relation":{},"ISSN":["2674-0826"],"issn-type":[{"value":"2674-0826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"article-number":"1717841"}}