Retinopathy: variable clinical spectrum and post-endarterectomy changes.

BACKGROUND The Carotid Artery Insufficiency Retinopathy (CAIR) is an uncommon sign of carotid artery obstruction. It is mainly found in patients with complete occlusion or severe obstruction of internal Carotid Artery (ICA). Retinopathy is caused by progressive and chronic hypoxia to ocular tissues. The purpose of the study is to describe the variable presentation of CAIR in patients with internal carotid artery stenosis and to asses the resolution of retinopathy in patients who had carotid endarterectomy. METHODS Records of the patients with confirmed internal carotid artery stenosis were reviewed. Patients' demographic data and way of presentation to ophthalmologist was recorded. Associated systemic vascular diseases were also recorded on the proforma. Records of the patients with confirmed internal carotid artery stenosis were reviewed. RESULTS Thirteen eyes of 10 patients were included in study with male to female ratio of 9:1. Patients' clinical presentation ranged from scattered blot haemorrhages to ocular ischemic syndrome. Patients presented with retinopathy at different stages. The presentation of retinopathy varied from scattered blot haemorrhages to ocular ischemic syndrome. Endarterectomy resolved CAIR in 2 out of 3 patients, with one patient having bilateral resolution. CONCLUSION CAIR should be suspected if retinopathy is unilateral. On the other hand patients with asymptomatic Carotid artery stenosis should be examined for signs of ocular ischemia. All patients with CAIR should be investigated for cardiovascular diseases. Endarterectomy in selected patients can resolve CAIR.