Ischemia-Guided Myocardial Revascularization: the Oculo-ischemic Reflex

DOI: 10.5935/abc.20140047 In stable coronary artery disease, the indication for revascularization procedures based on the anatomical detection of stenotic coronary lesions, regardless of clinical findings, has been called ‘oculostenotic reflex’. That expression was ironically created by Topol E. and Nissen S., and aimed at warning about the fact that not every obstruction has to be approached invasively1. At least from the academic viewpoint, that reflex seems to have been overcome, being currently considered an overtreatment2. However, the belief that the demonstration of myocardial ischemia by use of complementary methods indicates the need for revascularization still persists, and has been called ‘oculo-ischemic reflex’.