Significant carotid artery narrowing present in some glaucoma patients

Significant carotid artery stenosis presented in 17% of patients with asymmetric, low-tension or progressive glaucoma, even though those cases had good IOP control, indicating that potential at-risk patients should have a carotid artery Doppler scan, a study found.

Mostafa A. Elgohary, MD, FRCS(ED), and colleagues reviewed 16 retrospective case reports and prospective, noncomparative case series of 58 patients who were referred for ophthalmic manifestations of significant carotid artery stenosis. They performed carotid Doppler ultrasound to assess for significant carotid artery stenosis and presented the results in a poster at the American Academy of Ophthalmology meeting.

In the larger case series, 17% of asymmetric, low-tension or progressive glaucoma patients had significant carotid artery stenosis. It was also present in 17% of patients with transient ischemic attacks and 13% of patients with amaurosis fugax.

The researchers said that while the study was small, it could point to potential risk.

"It may be prudent to consider referring patients with progressive or asymmetric glaucoma despite normal eye pressure — especially in the presence of cardiovascular risk factors such as hypertension, hypercholesterolemia or ischemia heart disease — for carotid artery Doppler scan to pick up those who could be at high risk for stroke and may benefit from carotid artery treatment," they said.