Risk factors associated with the emergence and progression of ocular ischemic syndrome in carotid artery stenosis

Introduction. The ocular ischemic syndrome (OIS) is a condition characterized by insufficient blood supply to the eye due to occlusion or hemodynamically significant stenosis of the internal carotid artery.

Aim. To study the risk factors for the occurrence and progression of OIS.

Materials and methods. The study included 91 patients divided into two groups: Group I (61 patients with OIS) and Group II (30 control patients). The study design was cross-sectional, allowing for the identification of potential risk factors. Data collection was performed using a standardized questionnaire and medical records, as well as duplex scanning of the brachiocephalic arteries.

Results. The results showed that the main risk factors increasing the likelihood of OIS are stenosis of the vertebral carotid artery (VCA) greater than 70% (AUC = 0.968; 95% CI: 0.925–1.000, p < 0.001) and occlusion of the VCA (AUC = 0.935; 95% CI: 0.864–1.000, p < 0.001). Other identified risk factors include nicotine dependence, arterial hypertension, dyslipidemia, obesity, and diabetes mellitus. The combination of risk factors for stenosis of the VCA greater than 70% includes nicotine dependence, arterial hypertension, dyslipidemia, and obesity, with a sensitivity of 88.6% and specificity of 91.4%. For VCA occlusion, key factors include arterial hypertension, obesity, and diabetes mellitus, with a sensitivity of 81.3% and specificity of 84.2%.

Discussion. Our study identified key factors such as carotid artery stenosis, arterial hypertension, and diabetes mellitus that contribute to the development of ocular ischemic syndrome, which is consistent with findings from other studies. The severity of carotid artery stenosis is an important predictor of eye ischemia, as it directly affects blood supply to the ocular artery.

Conclusions. The study allows for the identification of associations between risk factors and ocular ischemic syndrome, which may facilitate the development of prevention and treatment strategies, as well as the implementation of artificial intelligence for diagnosis. Key risk factors such as arterial hypertension, dyslipidemia, and obesity significantly increase the likelihood of developing OIS in cases of stenosis and occlusion of the carotid arteries.

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