The Intima Media Thickness (IMT) as Measured by Carotid Ultrasonography in Patients with Retinal Vascular Diseases

Sang Jin Seo; Hyun Duk Jang; Soo Jung Lee; Jung Min Park

doi:10.3341/jkos.2014.55.4.541

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Seo, Jang, Lee, and Park: The Intima Media Thickness (IMT) as Measured by Carotid Ultrasonography in Patients with Retinal Vascular Diseases

Original Article

J Korean Ophthalmol Soc 2014;55(4):541-547.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.4.541

The Intima Media Thickness (IMT) as Measured by Carotid Ultrasonography in Patients with Retinal Vascular Diseases

Sang Jin Seo, MD¹, Hyun Duk Jang, MD², Soo Jung Lee, MD, PhD³, Jung Min Park, MD, PhD¹

¹Department of Ophthalmology, Maryknoll Hospital, Busan, Korea

²Kim’s Eye Clinic, Cheongju, Korea

³Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

Address reprint requests to Jung Min Park, MD, PhD Department of Ophthalmology, Maryknoll Hospital, #121 Junggu-ro, Jung-gu, Busan 600-730, Korea, Tel: 82-51-461-2469, Fax: 82-51-462-3534 E-mail: pjm1438@hanmail.net

Received 15 June 20134 October 2013 Accepted 1 March 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the findings of carotid ultrasonography performed on patients with retinal vascular disease and to determine the risk of cardiovascular disease and association of retinal vascular disease and cardiovascular disease.

Methods

From December 2009 to May 2012, patients diagnosed with central retinal artery occlusion (CRAO, n = 18), central retinal vein occlusion (CRVO, n = 23), and branch retinal vein occlusion (BRVO, n = 68) underwent carotid ultrasonography. We evaluated the intima-media thickness (IMT) of the common carotid artery (CCA) and the internal carotid artery (ICA), stenosis and the number of plaques, and then compared these results with those of a healthy control group (n = 221).

Results

The mean CCA-IMT and ICA-IMT were significantly higher in the CRAO and BRVO groups compared with the control group. On the contralateral side, CCA-IMT was increased in the CRAO, BRVO, and CRVO groups and ICA-IMT was increased in the CRAO and BRVO groups compared with the control group. Contralateral CCA stenosis was higher in the CRVO group (9.1%) and ipsilateral ICA stenosis in CRAO group (21.7%) was significantly higher than that of the control group. Plaque was observed better in all groups compared with the control group. The proportion of patients risk for cardiovascular disease, i.e. those who had IMT thickenesses more than 1.0 mm, was higher in the CRAO and BRVO groups compared with the control group.

Conclusions

The carotid ultrasound findings of patients with retinal vascular diseases showed increased IMT and plaque. The group of patient at risk for cardiovascular disease, which was defined with carotid artery IMT, was higher in patients with retinal vascular disease. Therefore, in patients with retinal vascular disease, carotid artery ultrasonography and the overall management and treatment of cardiovascular disease are necessary.

Keywords: Branch retinal artery occlusion, Carotid ultrasonography, Central retinal artery occlusion, Central retinal vein occlusion, Intima-media thickness

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Figure 1.

The measurement diagram of carotid artery in-tima-media thickness. The IMT is define as a distance between lumen intima interface and media adventitia interface at the far wall of carotid artery. In the B-mode ultrasonography of carotid artery, the intima show hyperechoic, the media show hy-poechoic and the adventitia show hyperechoic.

Figure 2.

Comparisons of the ipsilateral carotid intima-media thickness among the patients with retinal vascular disease and the control group. CRAO = central retinal artery occlusion; CRVO = central retinal vein occlusion; BRVO = branch retinal vein occlusion; CCA = common carotid artery; ICA = internal carotid artery; IMT = intima-media thickness.

Figure 3.

Proportion of Carotid artery stenosis in the patients with retinal vascular disease and the control group. CRAO = central retinal artery occlusion; CRVO = central retinal vein occlusion; BRVO = branch retinal vein occlusion; CCA = common carotid artery; ICA = internal carotid artery.

Figure 4.

Proportion of high risk groups according the ipsilateral carotid artery IMT in the patients with retinal vascular disease and the control group. CRAO = central retinal artery occlusion; CRVO = central retinal vein occlusion; BRVO = branch retinal vein occlusion; CCA = common carotid artery; ICA = internal carotid artery; IMT = intima-media thickness.

Table 1.

Carotid ultrasonographic and Laboratory finding in the patients with retinal vascular disease and the control groups

	CRAO (n = 23)	CRVO (n = 18)	BRVO (n = 68)	Control (n = 221)
Ipsilateral CCA-IMT (μm)	1.15 ± 0.48^*	0.80 ± 0.26	0.82 ± 0.18^*	0.73 ± 0.17
Contralateral CCA-IMT (μm)	1.12 ± 0.47^*	0.83 ± 0.23^*	0.79 ± 0.14^*
Ipsilateral ICA-IMT (μm)	1.09 ± 0.62^*	0.73 ± 0.22	0.77 ± 0.32^*	0.66 ± 0.18
Contralateral ICA-IMT (μm)	1.12 ± 0.48^*	0.78 ± 0.42	0.74 ± 0.36^*
Mean age (year)	67.78 ± 9.52	62.6 ± 9.85	60.80 ± 10.79	60.07 ± 8.06
Sex (F:M) (%)^†	44:56^*	47:53^*	66:34	67:33
DM (%)^†	34.1%^*	20%^*	16.3%^*	10%
HTN (%)^†	82.9%^*	77.8%^*	64.3%^*	17.6%
Number of Plaque	2.04 ± 1.22^*	0.83 ± 0.89^*	0.68 ± 0.83^*	0.33 ± 0.68

Values are presented as mean ± SD.

CRAO = central retinal artery occlusion; CRVO = central retinal vein occlusion, BRVO = branch retinal vein occlusion; CCA = common carotid artery; ICA = internal carotid artery; IMT = intima-media thickness; DM = diabetes; HTN = hypertension.

^* p-value < 0.05 (vs Control)

^† Chi-square test.

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