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.

A review of 50 cases of aphakic detachment in Peshawar, North West Frontier Province of Pakistan.

BACKGROUND: This prospective study was conducted at Khyber Teaching Hospital Peshawar, North West Frontier Province (NWFP) of Pakistan over the period of 16 months. It was to assess the demographic pattern, mode of presentation, treatment modalities and postoperative result of aphakic retinal detachment. This study also compared the incidence of aphakic retinal detachment in intracapsular versus extracapsular cataract extraction as well as the duration between cataract surgery and retinal detachment. PATIENTS AND METHOD: A total of 50 patients were recruited in this prospective study. A Proforma was specially designed for this purpose. Detailed history with reference to age, sex, presenting complaints, spectacle wear, previous ocular surgery, duration of surgery/laser treatment, systemic and family history was taken. All patients had detailed ophthalmic examination, underwent conventional retinal reattachment surgery, and were followed up for 6 months. RESULTS: Of the total number studied, 86% of the patients were males; only 14% were females, with a mean age of 58 years. The overall anatomical success was achieved in 40 (80%) eyes. The visual acuity of 6/12 and better was achieved in 8 (16%) eyes. 20 (40%) eyes attained a vision of 6/18 to 6/36. 12 (24%) eyes had a vision between 6/60 to CF 3m. The vision could not be improved beyond CF 3m in 10 (20%) eyes. CONCLUSION: Vitreous loss during cataract surgery is the most common cause of aphakic retinal detachment. The risk is maximal in the first and second year. The overall anatomical attachment achieved through conventional retinal detachment surgery is 80%.