Ocular Ischemic Syndrome

Ocular ischemic syndrome is a clinical entity which occurs secondary to chronic retinal and choroidal hypoxy due to to chronic ocular hypoperfusion. Carotid atherosclerotic vascular disease is the most frequent etiology. Dissecting carotid artery aneurysm, giant cell arteritis, moyamoya disease, Takayasu arteritis, Behçet’s disease, and other inflammatory diseases leading to carotid artery obstruction may also play a role in the etiology. Visual loss which is not acute and ocular angina are the main symptoms. Retinal venous dilatation, deep retinal hemorrhages, microaneurysms are the major findings seen at the posterior segment. Anterior and posterior segment neovascularization occur as the disease progresses. Retinal photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) are the main treatment modalities for ocular neovascularization. Systemic morbidity and mortality are high. Carotid endarterectomy is the principal treatment of the systemic disorder.