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Low concentrations of lithium and cyclooxygenase inhibitors enhance endothelin-1 (ET-1)-induced contractions in human temporal artery, but not in porcine ophthalmic artery.

Endothelins are a recently discovered group of potent vasoconstrictor peptides synthesized by endothelial cells and other tissues in various species, which seem to participate in the regulation of vascular tonus. Abnormalities in vasoactivity in the head may be an important event in headache pathophysiology, although the mechanisms responsible for such constrictions and/or dilations are not known. The endothelium and its constrictor peptide, endothelin, may play a key role in such mechanisms. Of the various drugs used in the treatment of headache, lithium is an accepted treatment for cluster headache, and indomethacin is the drug of choice for the associated condition chronic paroxysmal hemicrania. The mechanism of action of these drugs in these headaches is not known. Due to the possible involvement of endothelin in headache disorders, the objective of this study was to verify the effects of lithium and cyclooxygenase inhibitors (indomethacin, acetylsalicylic acid and naproxen) on endothelin-1 (ET-1)-induced contractions in isolated human temporal arteries and porcine ophthalmic arteries. It was found that all drugs increased the (ET-1)-induced contractions in human temporal arteries. Conversely, there were no significant changes induced by the drugs in porcine ophthalmic arteries. These results are consistent with the variation of activity often seen in different vascular beds and between species. The potential importance of such reactions for the understanding of vascular changes putatively involved in headache development and treatment is discussed.

Animals↗

Relationship between ophthalmic artery blood flow and recanalization of occluded carotid artery. Ultrasonic Doppler study.

Ophthalmic artery blood flow in 5 patients with internal carotid artery occlusion of sudden onset was monitored by an ultrasonic Doppler flowmeter to investigate the possible relationship to spontaneous recanalization of the occluded artery. The occluded internal carotid arteries of 2 patients were confirmed angiographically to recanalize and the reversed flow of their ophthalmic arteries changed to physiological flow after the recanalization. The ophthalmic artery blood flow remained reversed in 2 patients whose occluded internal carotid arteries did not recanalize on the follow up angiograms. In the other patient, whose ophthalmic artery blood flow was not detected by the ultrasonic Doppler flowmeter in the acute stage, physiological flow through the ophthalmic artery was detected later. The occluded internal carotid artery did not recanalize and this physiological ophthalmic artery blood flow was filled through the circle of Willis.

Acute Disease↗

Carotid occlusive disease: effect of complete occlusion of internal carotid artery on intraocular pulse/pressure relation and on ophthalmic arterial pressure.

The intraocular pressure (IOP), the intraocular pulse to pressure (pulse/pressure) relationship, and the ophthalmic arterial pressure have been measured in 20 patients with either unilateral or bilateral hemodynamically significant lesions of the internal carotid arteries (ICA) as determined from arteriography. Studies were repeated in 5 of hte patients after surgical endarterectomy on the obstructed ICA. In age matched normal subjects the pulse/pressure relations were symmetrical in pairs of eyes, and the ophthalmic arterial systolic pressure was 89.0 +/- 2.1 mm Hg; this was 66 +/- 1% of the brachial arterial systolic pressure. In 19 of 20 patients with carotid occlusive disease in this study the IOP, pulse amplitudes and the pulse/pressure relationships differed in pairs of eyes. The ophthalmic arterial systolic pressure on the sides with 95 to 100% ICA stenosis was 49.9 +/- 4.05 mm Hg, which was 33 +/- 3% of the brachial arterial systolic pressure. In the remaining eyes the degree of stenosis of the ipsilateral ICA was 36.5 +/- 7.9%; the corresponding eyes had an ophthalmic arterial systolic pressure of 70.f1 +/- 51.18 mm Hg, which was 45 +/- 4% of the brachial arterial systolic pressure. Endarterectromy of the occluded arteries caused a significant increase in the ophthalmic arterial pressure on the ipsilateral side and a smaller increase in the contralateral eye; these changes were associated with a statistically significant increase in the intraocular pulse and improvement in the pulse/pressure relation.

Aged↗

[Ophthalmic artery aneurysms].

INTRODUCTION: Ophthalmic artery aneurysms are infrequent lesions and they have very specific particularities. OBJECTIVE: to present the anatomoclinical and surgical characteristic of our patients with ophthalmic aneurysms and to analyze our surgical results. PATIENT AND METHODS: 604 patients with intracranial aneurysms were operated on between January 1982 and December 2004. There were 50 patients with ophthalmic artery aneurysms. Average age was 52 years, 80% were women, 60% harbored multiple aneurysms and 20% were giant lesions. 12% had bilateral ophthalmic aneurysms. 20% of ophthalmic aneurysms were incidental. 50% had ophthalmological manifestations; however, this presentation occurred in 100% of the patients with large and giant aneurysms. Initially, 12% of ophthalmologic disorders were missed. We utilized unilateral or bilateral pterional approach associated to others in multiple aneurysms. We performed retrograde decompression- suction technique modified for large and giant aneurysms. RESULTS. Thirty patients (60%) obtained a complete recovery, fourteen patients (28%) an incomplete recovery and two were seriously disabled. There were not patients in vegetative state. There were four deaths (8%). 50% of postoperatory deficits disappeared and 64% of ophthalmologic disorders improved three months later. CONCLUSION: Microsurgical method allowed to treat unique, multiple, bilateral, large and giant ophthalmic aneurysms with good recovery of neurological and visual deficits.

Cerebral Angiography↗

[Treatment of central retinal artery occlusion with thrombolysis via superselective ophthalmic artery catheterization].

OBJECTIVE: To investigate the therapeutic effect of thrombolysis via superselective ophthalmic artery catheterization for treatment of central retinal artery occlusion (CRAO). METHOD: Urokinase was directly infused via ophthalmic artery (OA) or common carotid artery by catheterization after angiography into 4 eyes of 4 patients with CRAO, The times of onset ranging from 7 to 14 days. RESULTS: The visual acuity was significantly improved in 2 eyes. No visual change was found in 2 eyes in which the beginning part of internal carotid artery (ICA) or OA was occluded. There was no complications. CONCLUSIONS: Good results were obtained in the eyes in which thrombolysis was launched early in the course of the disease and urokinase was successfully infused into the OA. It seems that there is no effect for the eyes complicated with occlusion in ICA and OA.

Adult↗

[Blood flow velocity in the ophthalmic artery measured by Doppler ultrasonography during cardiopulmonary bypass--usefulness for cerebral perfusion monitor].

Brain blood flow is supplied from the internal carotid artery, and the ophthalmic artery is the first branch of the internal carotid artery. We studied how blood flow velocity in the ophthalmic artery (OAV) changes during cardiopulmonary bypass (CPB) and investigated whether it can be used to monitor brain blood flow during CPB. In 13 open heart surgeries in adults, OAV and blood flow velocity in the common carotid artery (CAV) were measured with Doppler ultrasonography, and blood flow volume in the brachiocephalic artery (BA flow) was measured simultaneously with an electromagnetic flow meter. Maximal blood flow velocity in the ophthalmic artery (OAVmax) and the common carotid artery (CAVmax) were 0.27 +/- 0.13 m/sec and 0.64 +/- 0.40 m/sec, BA flow was 486 +/- 226 ml/min before CPB. When CPB pump flow was varied (2.4, 2.2, 2.0, 2.2, 2.4 l/min/m2), the parameters during and after CPB changed as follows (as percentage of pre-CPB levels): OAVmax, 58.1%, 50.9%, 37.6%, 49.4%, 64.7%, 108.4%; CAVmax, 67.0%, 58.0%, 48.2%, 113.6%, 105.5%, 134.3%; and BAflow, 87.3%, 39.8%, 53.9%, 50.5%, 95.0%, 159.8%. Our results indicate that OAVmax more accurately reflects changes in pump flow than does CAVmax and BA flow. Because vessel resistance in the ophthalmic artery was small during CPB, OAVmax was thought to be determined mainly by CPB pump flow. OAVmax was useful for monitoring brain blood flow during CPB.

Adult↗

Wavelet-based neural network analysis of ophthalmic artery Doppler signals.

In this study, ophthalmic artery Doppler signals were recorded from 115 subjects, 52 of whom had ophthalmic artery stenosis while the rest were healthy controls. Results were classified using a wavelet-based neural network. The wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of ophthalmic artery Doppler signals. A multilayer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis in ophthalmic arteries. In order to determine the MLPNN inputs, spectral analysis of ophthalmic artery Doppler signals was performed using wavelet transform. The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All data sets were obtained from ophthalmic arteries of healthy subjects and subjects suffering from ophthalmic artery stenosis. The correct classification rate was 97.22% for healthy subjects, and 96.77% for subjects having ophthalmic artery stenosis. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect ophthalmic artery stenosis.

Adult↗

Classification of the ophthalmic artery that arises from the middle meningeal artery in Japanese adults.

In a study of Japanese adults, we found that the orbital branch (OB) passing through the superior orbital fissure frequently anastomosed with the lacrimal artery or the ophthalmic artery (12/20). However, the OB passing through the meningo-orbital foramen (mof) only associationaly anastomosed with branches of the ophthalmic artery (4/79). Furthermore, the OB in the orbit, excluding the lacrimal gland as previously reported. We examined 116 cases in which the OB passed through the mof in 129 adult Japanese cadavers (45.0% in 258 sides). The OB passing through the mof was always distributed to the periorbital region and the area that it supplied was limited to the periorbita in about half of those cases. In another half of the cases (58/116), the area supplied included the lacrimal gland.

Adult↗

An anomalous ophthalmic artery arising from the middle meningeal artery.

A case of the left ophthalmic artery arising from the frontal branch of the middle meningeal artery was found in the cadaver of a 65 year-old Japanese man who died of senility. The original ophthalmic artery, much smaller than normal, arose from the internal carotid artery and communicated with a branch of the anomalous ophthalmic artery under the optic nerve. From this communicating branch, the central artery of the retina originated. The right ophthalmic artery was also anomalous. Though normal in origin and ramification, it passed under the optic nerve to reach the medial wall of the orbit.

Aged↗

Reversible abnormalities in the ophthalmic arteries detected by color Doppler imaging.

PURPOSE: To demonstrate dynamic, reversible abnormalities in ophthalmic artery blood flow velocity identified with color Doppler imaging (CDI) in patients with clinical findings of ocular ischemia with and without carotid artery stenosis. METHODS: One patient with ocular ischemia and normal carotid arteries had abnormal ophthalmic artery velocities demonstrated by CDI. Two other patients with reversed ophthalmic artery flow and critical internal carotid artery stenosis were studied before and after carotid endarterectomy. Peak systolic and diastolic velocities as well as pulsatility indices of ophthalmic, posterior ciliary, and central retinal arteries were calculated. RESULTS: The patient who had ocular ischemic syndrome without carotid artery stenosis showed increased ophthalmic artery velocities initially, and reversal of flow within the ophthalmic artery subsequently developed. Clinical findings and symptoms improved gradually as ophthalmic artery, posterior ciliary, and central retinal artery velocities increased. The patients with critical internal carotid artery stenosis had reversed ophthalmic artery blood flow initially which reverted to normal after carotid endarterectomy. CONCLUSION: Ocular ischemic syndrome may occur due to abnormal blood flow in the ophthalmic artery in the absence as well as in the presence of carotid artery stenosis. Flow dynamics in the ophthalmic artery and its branches can be shown by CDI to revert toward normal as the clinical findings improve spontaneously or after opening an occluded carotid artery.

Aged↗

[Intra-arterial fluorescein angiography using ophthalmic artery catheter in an experimental model].

BACKGROUND: For the purpose of retinal angiography sodium fluorescein can be applied oral, intravenously or, via special catheters, intraarterially. In the latter procedure the imaging is different, which will be examined in this paper. There come up aspects, which supplement the possibilities of conventional sequence- or videoangiography and contrast the experimental technique of angiography by temperature-sensitive liposomes. MATERIAL AND METHODS: Intraarterial retinal angiography was carried out on 15 rabbits through a microcatheter and fluorescein was applied in different quantities and concentrations. RESULTS: Because of the direct inflow to the retina, the resulting images had more contrast and interference due to recirculating fluorescein was nearly excluded. With increased perfusion pressure, functional tests of circulation were possible. By administering small amounts of fluorescein 10% (0.01-0.02 ml/min) via the catheter, continuous perfusion provided continuous presentation of hemodynamics, by making visible retinal pulsation. CONCLUSIONS: The intraarterial fluorescence-angiography offers a new possibility for evaluating retinal circulation under increased pressure and for analysis of the retinal pulse wave. The procedure gets a clinical perspective by combined therapeutical application.

Animals↗

Effect of carotid endarterectomy on the ophthalmic artery.

BACKGROUND: To evaluate the effect of carotid endarterectomy on ophthalmic artery flow direction and peak systolic flow velocity, the authors examined the ophthalmic artery on 32 patients who had undergone carotid endarterectomy. METHODS: The 32 patients had more than 70% stenosis of the internal carotid artery at its origin on angiography. The ophthalmic artery ipsilateral to the carotid endarterectomy was evaluated by the ophthalmic artery color Doppler flow imaging before surgery and then at one week, one month, and three months after surgery. FINDINGS: (1) Before carotid endarterectomy: eight patients showed reversed ophthalmic artery direction. In the other 24 patients with antegrade ophthalmic artery flow direction, the average peak systolic flow velocity was 0.17+/-0.10 m/sec. (2) At one week after carotid endarterectomy: The reversed ophthalmic artery flow direction was resolved in each patient. The average peak systolic flow velocity in the patients with preoperative antegrade flow rose significantly to 0.28+/-0.10 m/sec (p<0.05). (3) At one month and three months after carotid endarterectomy: All patients showed the antegrade ophthalmic artery flow direction. The average peak systolic flow velocities showed no significant change compared to the value at one week after carotid endarterectomy. (4) During the followed up period, there was no patient showing worsening or recurrence of clinical symptoms including the visual symptoms. INTERPRETATION: Carotid endarterectomy brought about the correction of the reversed flow and an increase in the peak systolic flow velocity of the ipsilateral ophthalmic artery immediately after surgery.

Aged↗

[Dissection of the internal carotid artery with ascending thrombosis of the ophthalmic artery as a rare differential diagnosis of post-traumatic amaurosis].

The case of a 30-year-old patient is reported who presented with a right-sided amaurosis fugax and a simultaneous frontobasal fracture that had occurred after a fall. By CT angiography and MRI angiography obstruction of the ophthalmic artery following a dissection of the internal carotid artery with ascending thrombosis could be demonstrated. There was a lack of further neurological deficits because of sufficient perfusion of the cerebral arteries by the arterial circle of the cerebrum. Among the etiological variety of types of posttraumatic amaurosis, this rare cause should be taken into consideration in the etiology, diagnosis and therapy, if appropriate.

Adult↗