Correlation Analysis Of Ocular Hemodynamic Parameters And Ischemic Stroke In Patients With Unilateral Moderate Carotid Artery Stenosis

BackgroundIschemic stroke with carotid stenosis is the most common type of stroke.The ophthalmic artery,the first branch of internal carotid artery,has the same embryonic origin as the craniocerebral vessels,the moderate carotid artery stenosis is the most common stenosis type of cardiac and cerebral blood accidents.The ocular hemodynamic changes of mild carotid artery stenosis are not obvious,and severe carotid artery stenosis often has serious complications.Early diagnosis and prevention of ischemic stroke have always been the focus of attention.Ocular blood flow parameters in patients with moderate carotid stenosis may further assess the risk of stroke.ObjectiveTo evaluate the value of retrobulbar of flow parameters in the risk assessment of ischemic stroke in patients with unilateral moderate carotid stenosis,and to analyze the clinical significance of each blood flow parameter.MethodsIn 91 cases of unilateral moderate carotid stenosis in ischemic stroke patients(group A)and 51 cases of healthy controls(group B),measured with color doppler ultrasound ophthalmic artery,central retinal artery systolic peak systolic velocity(PSV),end of diastolic blood flow to the minimum velocity(EDV),resistance index(RI),pulse index(PI),the highest systolic blood flow velocity and the late diastolic blood flow to the minimum speed ratio(PSV/EDV referred to S/D).The same patients in the ischemic stroke group were divided into the eye side with carotid stenosis(Group A1)and the non-carotid stenosis(group A0).The diagnostic thresholds and efficacy of each parameter were evaluated,and the clinical significance of each parameter was analyzed.The correlation between each parameter and ischemic stroke with moderate carotid artery stenosis was also analyzed.Results1.The PSV and EDV of OA in A1 group were lower than those in B group,the PI,RI and S/D were higher than those in B group,and the PSV,EDV and S/D of CRA in A1 group were lower than those in B group(all P<0.05).The PSV and EDV of OA in A1 group were lower than those in A0 group(P<0.05).The PSV and EDV in OA of A0 group were higher than those of B group(P>0 0.05).2.Logistic regression analysis showed that the OR values of EDV,RI and S/D in OA were >1.3.RI in OA had a higher diagnostic efficiency for ischemic stroke with moderate carotid stenosis(area under the curve was 0.899,best diagnostic threshold was 0.655,sensitivity was 88.6%,specificity was 66.7%).ConclusionThe ipsilateral eye blood flow in ischemic stroke with unilateral moderate carotid stenosis presented low-speed and high-resistance changes.The intracranial ischemia on the stenosis side of the carotid artery is more severe,and the hemodynamics of the non-stenosis side of the ocular artery may play a compensatory role to some extent.EDV,RI and S/D in OA are risk factors for ischemic stroke,The increase of RI in OA may be related to the increased risk of stroke.