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Ocular ischaemic syndrome
Retina & Vitreous
Key Points
- •OIS results from chronic ocular hypoperfusion due to carotid stenosis >70%; characterised by venous stasis retinopathy, NVI (~67%), and a 5-year mortality of ~40% from cardiovascular causes
- •Key differentiators from CRVO: veins are dilated but NOT tortuous, haemorrhages are mid-peripheral (not posterior pole), IOP is low/normal (not elevated), and FFA shows prolonged AV transit time
- •Spontaneous retinal arterial pulsation is pathognomonic; FFA shows AV transit time >15–20 seconds; carotid Doppler is the first-line investigation
- •Treatment priority is systemic: carotid endarterectomy (NASCET: stroke risk reduced from 26% to 9%), antiplatelet therapy, statins, risk factor control - ophthalmic management (PRP, anti-VEGF, NVG treatment) is secondary
- •OIS is a marker of severe atherosclerosis - always perform comprehensive cardiovascular evaluation including carotid imaging, ECG, echocardiography, and vascular surgery referral
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Keep reading Ocular ischaemic syndrome
16 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Clinical features