Manifestaciones neuroftalmológicas de la estenosis carotídea

Yanelis Maimó Gallego, Tamara Juvier Riesgo, Noemy Bory Vargas, Augusto César González Pérez

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Resumen

Objetivo: Describir las alteraciones neuroftalmológicas que se asocian a la estenosis carotídea.

Adquisición de la evidencia: Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Medline, Cumed, Lilacs, Google académico y SciELO. Se consultaron 61 artículos publicados en inglés y español, de 2015 a 2020, que versaban sobre las diferentes manifestaciones neuroftalmológicas de la estenosis carotídea. Los descriptores de búsqueda principales fueron: manifestaciones neuroftalmológicas AND estenosis carotídea, carotid stenosis AND epidemiology, ocular ischemic syndrome, amaurosis fugax AND carotid stenosis, optic nerve AND carotid stenosis, choroid AND carotid stenosis, retina AND carotid stenosis.

Resultados: Las manifestaciones de la insuficiencia carotídea abarcan un espectro que incluye episodios transitorios de ceguera monocular (amaurosis fugaz), retinopatía por estasis venosa y síndrome isquémico ocular. Se puede detectar la presencia de retinopatía hipertensiva asimétrica en el fondo de ojo, incluso, pequeños émbolos de colesterol o cambios vasculares. La tomografía de coherencia óptica es útil en estos casos para detectar cambios en la densidad microvascular, el grosor de la retina, el grosor coroideo y las capas de fibras nerviosas. El electrorretinograma puede ser una herramienta valiosa para la detección de la isquemia retiniana en casos asintomáticos.

Conclusiones: En la estenosis carotídea son manifestaciones frecuentes la amaurosis fugaz o el síndrome isquémico ocular, pero las alteraciones de retina, coroides o del nervio óptico pueden estar presentes en pacientes asintomáticos. Se ha demostrado que algunas herramientas como la tomografía de coherencia óptica y la angiografía retiniana son muy útiles para el diagnóstico temprano de la enfermedad.

Palabras clave

amaurosis fugaz; densidad microvascular retinal; estenosis carotídea; grosor coroideo; grosor retinal; manifestaciones neuroftalmológicas; síndrome isquémico ocular

Referencias

Morris DR, Ayabe K, Inoue T, Sakai N, Bulbulia R, Halliday A, et al. Evidence-based carotid interventions for stroke prevention: state-of-the-art review. J Atheroscler Thromb. 2017;24(4):373-87. Doi: 10.5551/jat.38745

Torres Damas EL, Igualada Correa JI. Factores de riesgos aterogénico y su relación con la lesión carotídea identificada por eco-doppler. Revista Cubana de Angiología. 2018 [citado: 10/06/2020];19(2):119-32. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1682-00372018000200006&Ing=es&nrm=iso

Wabnitz AM, Turan TN. Symptomatic Carotid Artery Stenosis: Surgery, Steting or Medical Therapy? Curr Treat Options Cardiovasc Med. 2017;19(8):62. Doi: 10.1007/s11936-017-0564-0

Sun R, Peng XY, You QS, Jiao LQ, Jonas JB. Central retinal artery pressure and carotid artery stenosis. Exp Ther Med. 2016;11(3):873-7. Doi: 10.3892/etm.2016.3013.

Salgado Castillo I, Triana Mantilla ME, Rodríguez Villalongan LE, Arpajón Peña Y, Hernández SearaI A. Características de la enfermedad cerebrovascular extracraneal en el municipio de arroyo Naranjo. Revista Cubana de Angiología. 2017;18(2). Disponible en: http://scielo.sld.cu./scielo.php%3Fscript%3Dsci_arttext%26pid%3DS1682-00372017000200002&ved=2ahUKEwjz343J0Y7qAhXMmuAKHbWiCPoQFjACegQIAhAB&usg=AOvVaw1sS8FVf0AW0Be1QZBeveLy.

Qu B, Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound. 2015;13:46. Doi: 10.1186/s12947-015-0041-4.

Cole JW. Large Artery Atherosclerotic Occlusive Disease. Continuum (Minneap Minn). 2017;23(1):133-57.

Kvickström P, Lindblom B, Bergstrom G, Zetterberg M. Amaurosis Fugax: risk factors and prevalence of significant carotid stenosis. Clin Ophthalmol. 2016 [citado: 19/05/2020];10:2165-70. Doi: 10.2147/OPTH.S115656.

Bess Constantén S, Alonso Alomá I, Sánchez Sordo E, López Nistal LM, Alonso Alomá I, Martínez Morales MA, et al. Anuario Estadístico de salud 2019. Dirección de Registros Médicos y Estadísticas de Salud. La Habana; 2020 [citado: 19/05/2020]. p. 31-32. Disponible en: https://files.sld.cu/bvscuba/files/2020/05/Anuario-Electr%C3%B3nico-Espa%C3%B1ol-2019-ed-2020.pdf

Guzik A, Cheryl Bushnell C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn). 2017;23(1):15-39.

Gu T, Aviv RI, Fox AJ, Johansson E. Symptomatic carotid near-occlusion causes a high risk of recurrent ipsilateral ischemic stroke. J Neurol. 2020;267(2):522-30. Doi: 10.1007/s00415-019-09605-5.

Chappell FM, Wardlaw JM, Brazzelli M, Best JJ. Doppler ultrasound, CT angiography, MR angiography, and contrast-enhanced MR angiography versus intra-arterial angiography for moderate and severe carotid stenosis in symptomatic patients. Cochrane Database Syst Rev. 2017;2017(2):CD007423. Doi: 10.1002/14651858.CD007423.pub2.

Sehatzadeh S. Is transient ischemic attack medical emergency? An evidence-based analysis. Ont Health Technol Assess Ser. 2015 [citado: 13/05/2020];15(3):1-45. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558772/#_ffn_sectitle

Gomez CR, Schneck MJ, Biller J. Recent advances in the management of transient ischemic attacks. F1000Res. 2017;6:1893. Doi: 10.12688/f1000research.12358.1.

Coutts SB. Diagnosis and Management of Transient Ischemic Attack. Continuum (Minneap Minn). 2017;23(1):82-92.

Jun B. Diagnostic considerations in patients presenting with transient vision loss. Mo Med. 2016 [citado: 19/05/2020];113(1):63-7. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139728/#_ffn_sectitle

van Hoof RH, Schreuder FH, Nelemans P, Truijman MT, van Orshoven NP, Schreuder TH, et al. Ischemic stroke patients demonstrate increased carotid plaque microvasculature compared to (ocular) transient ischemic attack patients. Cerebrovasc Dis. 2017 [citado: 19/05/2020];44(5-6):297-303. Doi: 10.1159/000481146.

Wang D, Li Y, Zhou Y, Jin C, Zhao Q, Wang A, et al. Asymptomatic carotid artery stenosis and retinal nerve fiber layer thickness. A community-based, observational study. PLoS One. 2017 [citado: 10/06/2020];12(5):e0177277. Doi: 10.1371/journal.pone. 0177277.

Ly A, Phu J, Katalinic P, Kalloniatis M. An evidence –based approach to the routine use of optical coherence tomography. Clin Exp Optom. 2019 [citado: 14/06/2020];102(3):242-59. Doi: 10.1111/cxo.12847.

Kashani AH, Chen CL, Gahm JK, Zheng F, Richter GM, Rosenfeld PJ, et al. Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications. Prog Retin Eye Res. 2017;60:66-100. Doi: 10.1016/j.preteyeres.2017.07.002.

Savastano MC, Lumbroso B, Rispoli M. In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography. Retina. 2015;35(11):2196-203. Doi: 10.1097/IAE.0000000000000635.

Çakir A, Düzgün, Demir S, Çakir Y, Ünal MH. Spectral domain optical coherence tomography findings in carotid artery disease. Turk J Ophthalmol. 2017;47(6):326-30. Doi: 10.4274/tjo.84565.

Biberoglu E, Eraslan M, Baltacioglu F, Midi I. Intraocular pressure and retinal nerve fiber layer thickness changes after carotid artery stenting. Turk J Ophthalmol. 2017;47(4):192-7. Doi: 10.4274/tjo.67809.

Volkers EJ, Donders RC, Koudstaal PJ, van Gijn J, Algra A, Kappelle LJ. Transient monocular blindness and the risk of vascular complications according to subtype: a prospective cohort study. J Neurol. 2016;263(9):1771-7. Doi: 10.1007/s00415-016-8189-x.

Pula JH, Kwan K, Yuen CA, Kattah JC. Update on the evaluation of transient vision loss. Clin Ophthalmol. 2016;10:297-303. Doi: 10.2147/OPTH.S94971.

Wu A, Sangha N. Limb-Shaking Syndrome with light-induced Amaurosis Fugaz: A rare presentation of near-occlusive carotid disease. Mov Disord Clin Pract. 2017;4(3):465-6. Doi: 10.1002/mdc3.12445.

Ting RJ, Hui M, Thoo C, Coroneo MT, Francis TC. Light –induced amaurosis: a rare manifestation of internal carotid stenosis. Cureus. 2019;11(10):e5817. Doi: 10.7759/cureus.5817.

Brown GC, Sharma S, Brown MM. Ocular Ischemic Syndrome. Section 2. Retinal Vascular Disease. In: Schachat AP editor. Ryan´s Retina. 6th Edition. China: Elsevier; 2018. p. 1227-37.

Luo J, Yan Z, Jia R, Luo R. Clinical analysis of 42 cases of ocular ischemic syndrome. J Ophthalmol. 2018;2018:2606147. Doi:10.1155/2018/2606147.

Hung JH, Chang YS. Ocular ischemic syndrome. CMAJ. 2017;189(23):E804. Doi: 10.1503/cmaj.160459.

Kim YH, Sung MS, Park SW. Clinical features of ocular ischemic syndrome and risk factors for neovascular glaucoma. Korean J Ophthalmol. 2017;31(4):343-50. Doi: 10.3341/kjo.2016.0067.

Kim DY, Joe SG, Lee JY, Kim JG, Yang SJ. Choroidal thickness in eyes with unilateral ocular ischemic syndrome. Ophthalmol. 2015;2015:620372. Doi: 10.1155/2015/620372.

Tamhankar MA. Transient Visual Loss or Blurring. En: Liu GT, Volpe NJ, Galetta SL, editors. Neuro – Ophthalmology 3rd Edition. Elsevier; 2018. p. 365-77.

Kang HM, Choi JH, Koh HJ, Lee SC. Significant changes of the choroid in patients with ocular ischemic syndrome and symptomatic carotid artery stenosis. PloS One. 2019;14(10):e0224210. Doi: 10.1371/journal.pone.0224210.

Qin Y, Ji M, Deng T, Luo D, Zi Y, Pan L, et al. Functional and morphologic study of retinal hypoperfusión injury induced by bilateral common carotid artery occlusion in rats. Sci Rep. 2019;9:80. Doi: 10.1038/s41598-018-36400-5.

Tripathy K, Mazumdar S. Recurrent retinal and choroidal ischemia in a case of ocular ischemic syndrome. Ther Adv Ophthalmol. 2019;11:2515841419848926. Doi: 10.1177/2515841419848926.

Konstantiniuk P, Steinbrugger I, Koter S, Muehlsteiner J, Wedrich A, Cohnert T. Impact of internal carotid endarterectomy on visual fields: a non-randomised prospective cohort study in Austria. BMJ Open. 2017 [citado: 19/05/2020];7(10):e017027. Doi: 10.1136/bmjopen-2017-017027

Lee CW. Optical Coherence Tomography Angiography Evaluation of Retinal Microvasculature Before and After Carotid Angioplasty and Stenting. Sci Rep. 2019;9:14755. Doi: 10.1038/s41598-019-51382-8.

Chou CC, Hsu MY, Lin CH, Lin CC, Wang CY, Shen YC. Risk of developing open-angle glaucoma in patients with carotid artery stenosis: a nationwide cohort study. PloS One. 2018 [citado: 14/06/2020];13(4):e0194533. Doi: 10.1371/journal.pone. 0194533.

Machalinska A, Kowalska-Budek A, Kawa MP, Kazimierczak A, Safranow K, Kirkiewics M. Association between asymptomatic unilateral internal carotid artery stenosis and electrophysiological function of the retina and optic nerve. J Ophthalmol. 2017 [citado: 14/06/2020];2017:4089262. Doi: 10.1155/2017/4089262.

Wray SH. Acute Visual Loss. Semin Neurol. 2016;36:425-32.

Meschia JF, Klaas JP, Brown RD, Brott TG. Evaluation and management of atherosclerotic carotid stenosis. Mayo Clin Proc. 2017;92(7):1144-57. Doi: 10.1016/j.mayocp.2017.02.020

Yang JY, Yang X, Li Y, Xu J, Zhou Y, Wang AX, et al. Carotid atherosclerosis, cerebrospinal fluid pressure, and retinal vessel diameters: the asymptomatic polivascular abnormalities in community study. PloS One. 2016;11(12):e0166993. Doi: 10.1371/journal.pone.0166993.

Wang H, Wang YL, Li HY. Subfoveal choroidal thickness and volume in severe internal carotid artery stenosis patients. Int J Ophthalmol. 2017 [citado: 20/06/2020];10(12):1870-1876. Doi: 10.18240/ijo.2017.12.13.

Lee JI, Gemerzki L, Boerker L, Guthoff R, Aktas O, Gliem M, et al. No alteration of optical coherence tomography and multifocal visual evoked potentials in eyes with symptomatic carotid artery disease. Front Neurol. 2019 [citado: 20/06/2020];10:741. Doi: 10.3389/fneur.2019.00741.

Heßler H, Zimmermann H, Oberwahrenbrock T, Kadas EM, Mikolajczak J, Brandt AU, et al. No Evidence for Retinal Damage Evolving from Reduced Retinal Blood Flow in Carotid Artery Disease. BioMed Res Int. 2015;2015:604028. Doi: 10.1155/2015/604028

Wang H, Li H, Zhang X, Qiu L, Wang Z, Wang Y. Ocular image and haemodynamic features associated with different gradings of ipsilateral internal carotid artery stenosis. J Ophthalmol. 2017 [citado: 20/06/2020];2017:1842176. Doi: 10.1155/2017/1842176

Agüero CA, Ramón N, Arzabe C, Lávaque AJ. Angiografía de retina por tomografía de coherencia óptica (OCT-A). Oftalmol Clin Exp. 2016 [citado: 20/06/2020];9(S):S1-S57.

Lahme L, Marchiori E, Panuccio G, Nelis P, Schubert F, Mihailovic N, et al. Changes in retinal flow density measured by optical coherence tomography angiography in patients with carotid artery stenosis after carotid endarterectomy. Sci Rep. 2018 [citado: 10/06/2020];8:17161. Doi: 10.1038/s41598-018-35556-4

Saito K, Akiyama H, Mukai R. Alteration of Optical Coherence Tomography Angiography in a patient with ocular ischemic syndrome. Retin Cases Brief Rep. 2019 Feb. Doi: 10.1097/ICB.0000000000000857.

Dattilo M, Newman NJ, Biousse V. Acute retinal arterial ischemia. Ann Eye Sci. 2018;3:28. Doi: 10.21037/aes.2018.05.04.

Hayreh SS. Central retinal artery occlusion. Indian J Ophthalmol. 2018;66(12):1684-94. Doi: 10.4103/ijo.IJO_1446_18.

Hjelmgren O, Strömberg U, Gellerman K, Thurin A, Zetterberg M, Bergström G. Does retinopathy predict stroke recurrence in type 2 diabetes patients: A retrospective study? PLoS One. 2019;14(1):e0210832. Doi: 10.1371/journal.pone.0210832

Drinkwater JJ, Davis TME, Davis WA. The relationship between carotid disease and retinopathy in diabetes: a systematic review. Cardiovasc Diabetol. 2020;19:54. Doi: 10.1186/s12933-020-01023-6.

Alonso N, Traveset A, Rubinat E, Ortega E, Alcubierre N, Sanahuja J, et al. Type 2 diabetes-associated carotid plaque burden is increased in patients with retinopathy compared to those without retinopathy. Cardiovasc Diabetol. 2015;14:33. Doi: 10.1186/s12933-015-0196-1

Zhang C, Wang S, Li M, Wu Y. Association Between Atherosclerosis and Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes. 2020;13:1911-20. Doi: 10.2147/DMSO.S246497

Moussa M, Sabry D, Soliman W. Macular choroidal thickness in normal Egyptians measured by swept source optical coherence tomography. BMC Ophthalmology. 2016;16(1):138. Doi: 10.1186/s12886-016-0314-1

Li S, Lang X, Wang W, Yang Y, Wang J, Li H, et al. Choroidal vascular changes in internal carotid artery stenosis: a retrospective cohort study in Chinese population. BMC Ophthalmol. 2019;19:215. Doi: 10.1186/s12886-019-1218-7.

Rabina G, Barequet D, Mimouni M, Rabinovitch Y, Wolf Y, Barack A, et al. Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up. J Ophthalmol. 2018 [citado: 19/05/2020]; 2018: 8324093. Disponible en: https://doi.org/10.1155/2018/8324093.

Akçay BIS, KardeşKardeş E, Maçin S. Evaluation of subfoveal choroidal thickness in internal carotid artery stenosis. Journal of Ophthalmology. 2016 [citado: 20/06/2020];2016:1-6. Doi: 10.1155/2016/5296048.

Uzun S, Yesilkaya Y, Pehlivan E. Comment on “Evaluation of subfoveal choroidal thickness in internal carotid artery stenosis” J Ophthalmology. 2016 [citado: 20/06/2020]; 2016: 7575643. Doi: 10.1155/2016/7575643.

Fu Z, Li H, Wang W, Wang Y. Research on association of the diameter of the internal carotid artery siphon and nonarteritic anterior ischaemic optic neuropathy. J Ophthalmol. 2019;2019:7910602. Doi: 10.1155/2019/7910602.

Yan J, Yang X, Wu J, Liu B, Jiao X, Li W, et al. Visual Outcome of Carotid Endarterectomy in Patients with Carotid Artery Stenosis. Ann Vasc Surg. 2019 [citado: 19/05/2020];58:347-56. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30769057/





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