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(Stroke. 2007;38:1377.)
© 2007 American Heart Association, Inc.

Research Reports

Altered Retrobulbar Hemodynamics in Patients Who Have Transient Monocular Blindness Without Carotid Stenosis

A-Ching Chao, MD; Hung-Yi Hsu, MD, PhD; Chih-Ping Chung, MD; Yen-Yu Chen, MD; May-Yung Yen, MD; Weng-Jang Wong, MD Han-Hwa Hu, MD

From the Department of Neurology (A.-C.C.), Kaohsiung Medical University and Hospital, Kaohsiung, Taiwan; Section of Neurology (H.-Y.H.), Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Section of Cerebrovascular Disease (C.-P.C., Y.-Y.C., W.-J.W., H.-H.H.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Ophthalmology (M.-Y.Y.), Taipei Veterans General Hospital, Taipei, Taiwan; and National Yang-Ming University. (H.-Y.H., C.-P.C., Y.-Y.C., H.-H.H., M.-Y.Y.), Taipei, Taiwan.

Correspondence to Han-Hwa Hu, MD, Professor of Neurology, Chief of Cerebrovascular Disease, Neurological Institute, Veterans General Hospital-Taipei, Taipei 112, Taiwan. E-mail hhhu{at}vghtpe.gov.tw

Background and Purpose— This study was to evaluate the retrobulbar hemodynamics in patients who have transient monocular blindness (TMB) without carotid stenosis.

Methods— Fifty-nine patients who have TMB without carotid stenosis were studied along with 59 age- and sex-matched controls. Color Doppler–imaging was used to study the retrobulbar hemodynamic by measuring the flow velocities (peak-systolic velocity, and end-diastolic velocity), vascular resistance indices (pulsatility index, and resistance index) in central retinal arteries, short posterior ciliary arteries, and ophthalmic arteries. The patients were divided into 2 groups according to the attack frequency: group 1 (occasional TMB, 2 or fewer attacks, 26 patients) and group 2 (frequent TMB, 3 or more attacks, 33 patients).

Results— The risk factors for atherosclerosis were similar between the cases and controls. The means of end-diastolic velocity were significantly lower in central retinal arteries and ophthalmic arteries, and the pulsatility index and resistance index were significantly higher in all the 3 retrobulbar vessels in TMB patients than for the controls. The differences between patients and controls were greater for the group-2 patients.

Conclusion— Patients who have TMB without carotid stenosis had altered retrobulbar hemodynamics with a generalized increase in vascular resistance in the retrobulbar arteries. The role of venous hypertension as an etiology needs further study.

Key Words: color Doppler • retrobulbar vessel • transient monocular blindness • venous hypertension