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Jo, Choi, Park, Lee, Lee, and Park: Initial Clinical Manifestations of Ocular Ischemic Syndrome in Koreans
Original Article

Journal of the Korean Ophthalmological Society 2019; 60(12): 1231-1237.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1231

Initial Clinical Manifestations of Ocular Ischemic Syndrome in Koreans

Yeon Ji Jo, MD, Seung Kwon Choi, MD, Sun Ho Park, MD, Jae Jung Lee, MD, Ji Eun Lee, MD, PhD, Sung Who Park, MD, PhD

Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.

Address reprint requests to Sung Who Park, MD, PhD. Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 49241, Korea. Tel: 82-51-240-7326, Fax: 82-51-242-7341, oph97@naver.com

Received 7 June 2019       Revised 11 July 2019       Accepted 6 December 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

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 clinical features of ocular ischemic syndrome in Koreans.

Methods

The medical records of patients who were presumed to have ocular ischemic syndrome by ophthalmic examination, and confirmed by carotid artery imaging, were retrospectively reviewed from 2010 to 2017.

Results

A total of 22 patients and 27 eyes were included in the study. Twenty patients were male. The average age was 64.2 years. Fifteen patients had hypertension and fifteen patients had diabetes mellitus. Twenty-one patients presented with acute visual impairment at the initial visit. The average best-corrected visual acuity (BCVA) was a LogMAR of 0.89 ± 0.65, with an average IOP of 16.1 ± 6.9 mmHg. Elevated IOP > 21 mmHg was noted in five eyes (18.5%). Iris neovascularization was the most common (13 eyes, 48.1%) feature in the anterior segment. Retinal hemorrhage was the most common feature in the fundus examination (23 eyes, 85.2%). The average central submacular thickness was 255.0 µm, and there was no macular edema except for one case with vitreomacular traction syndrome on optical coherent tomography.

Conclusions

A total of 90.9% of patients with ocular ischemic syndrome were males > 50 years of age. Most patients presented with acute visual impairment. There was no macular edema on optical coherent tomography of all eyes.

Keywords: Carotid artery stenosis, Macular edema, Ocular ischemic syndrome

Figures and Tables

Figure 1

Representative case of ocular ischemic syndrome patient (case 10). (A) Anterior photo showed neovascularization of the iris (white arrows). (B) Optical coherent tomography showed hyperreflectivity suggesting inner retina ischemia, but there was no macular edema. (C) Fundus photo showed dot-shaped retina hemorrhage (white arrow) and neovascularization (red arrow). (D) Fluorescein angiography showed retinal artery filling delay (20 seconds). (E) Computed tomography angiography showed total occlusion of the right internal carotid artery (blue arrow).

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Figure 2

Optical coherence tomography of 4 representative cases with ocular ischemic syndrome patient at the initial visit. (A–C) There was no macular edema, and the choroid thickness was thinner than the normal eye. (D) Only 1 of 27 eyes showed macular edema. The macular thickening might be originated from the vitreomacular traction.

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Table 1

Baseline characteristics of 22 patients who were diagnosed as ocular ischemic syndrome

jkos-60-1231-i001

Values are presented as mean ± standard deviation or number (%). LogMAR = logarithm of the minimum angle of resolution.

Table 2

The examination result of ocular ischemic syndrome at the first visit

jkos-60-1231-i002

AV = arteriovenous; CSMT = central subfield macular thickness; SFCT = subfoveal choroidal thickness; NVI = new vessels at the iris; logMAR = logarithm of minimal angle of resolution; M = male; F = female.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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