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Tek Taraflı Karotis Arter Stenozunda Diabetik Retinopati

Year 2019, Volume: 26 Issue: 2, 205 - 208, 01.06.2019
https://doi.org/10.17343/sdutfd.442266

Abstract

59 yaşında bayan hasta polikliniğimize sağ gözünde az görme şikayeti ile başvurdu. Öyküsünde 4 yıldır tip2 (DM) olduğu anlaşıldı. Oftalmolojik muayenede görme keskinliği (GK) sağda 0,15, solda 0,9 olarak saptandı.Göz içi basıncı her iki gözde 16 mmHg olarak gözlendi.Fundus muayenesinde sağ gözde optik disk başından vitre içine uzanan proliferatif fibrovasküler yapı saptandı. Sağ ve sol gözde, yer yer intraretinal hemoraji dışında başka bir bulgu gözlenmedi.Hastaya fundus fotoğrafı ve fundus flourescein anjiografisi çekildi. Hasta her iki göz arasında diyabetik retinopati (DRP) şiddeti farklı olduğu için kalp damar cerrahisi birimine konsülte edildi. Çekilen karotis arter anjiyografisinde sağ internal karotis arterde ileri derecede stenoz saptandı. Vakamızda olduğu gibi ileri derecede asimetrik tutulumlarda, iskemi şiddetini artırabilen karotis arter darlık veya tıkanıkları da göz önüne alınmalıdır. Tespit edilmemiş karotis hastalıkları, hastanın vital fonksiyonlar için daha hayati olabileceği için, asimetrik tutulumlu DRP’li olgularda karotis arterin muayenesi önerilir. Bu çalışmamızda asimetrik tutulumlu DRPye eşlik eden karotis arter stenozu olan bir olguyu sunmayı amaçladık.

References

  • 1. İnan S. Diabetik Retinopati ve Etiyopatogenezi. Kocatepe Tıp Dergisi. 2014;15(2):207-17.2. Marshall SM, Flyvbjerg A. Prevention and early detection of vascular complications of diabetes. BMJ : British Medical Journal. 2006;333(7566):475-80.3. Avcı E, Çakır E. Diyabetes Mellitusun Mikrovasküler Komplikasyonu: Diyabetik Nefropati. Selçuk Tıp Dergisi. 2014;30:15-8.4. Kocabora MS, Kocabora AG. Karotis Arter Hastalıklarında Göz Tutulumu. Kocaeli Tıp Dergisi. 2012;1:55-62.5. Retinal Vascular Disease. Diabetic Retinopathy, American Academy of Ophthalmology - Retina and Vitreous - Section 12. 2012-2013. p. 89-112.6. Özmert E. Diabetik Retinopati ve Makülopatinin Tanımı ve Sınıflaması. Ret-Vit. 2014;22:38-45.7. Batıoğlu F. Diabetik Retinopati - Anti-VEGF Tedavi. Ret-Vit. 2014;22:74-8.8. Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. The New England journal of medicine. 1994;331(22):1480-7.9. Murai S, Kusaka N, Umakoshi M, Itami H, Otsuka S, Nishiura T, et al. Stenting for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery Using Proximal Flow Blockade and Distal Protection System: A Technical Case Report and Literature Review. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2016;25(6):e98-e102.10. Li X, Ma X, Lin J, He X, Tian F, Kong D. Severe carotid artery stenosis evaluated by ultrasound is associated with post stroke vascular cognitive impairment. Brain and Behavior. 2017;7(1):e00606.

Diabetic Retinopathy in Unilateral Carotid Artery Stenosis

Year 2019, Volume: 26 Issue: 2, 205 - 208, 01.06.2019
https://doi.org/10.17343/sdutfd.442266

Abstract

A 59-year-old female patient was admitted to our polyclinic with complaints of low vision in her right eye. She has type 2 diabetes mellitus for 4 years. Her vision acuits was 0.15 in the right eye and 0,9 in the left eye. Intraocular pressure was 16 mmHg in both eyes. In the fundus examination of right eye, fibrovascular proliferation and intraretinal hemorrhage were seen in the right eye. In the fundus examination of left eye, intraretinal hemorrhages were seen. fundus fluorescein angiography (FFA) was performed. FFA result was similar with fundus examination. The patient was hospitalized for cardiovascular surgery because that diabetic retinopathy severity was different between both eyes. In the carotid angiography examination, a stenozis detected in the right internal carotid artery. As this cases carotid artery stenosis or obstructions that can increase the severity of ischemia must also be considered. Carotid artery examination is recommended in cases with asymmetric DRP, as undetected carotid diseases may be more vital for vital functions of the patient. In this study, we aimed to present a case that has asymetric diabetic retinopathy with carotid artery stenosis.

References

  • 1. İnan S. Diabetik Retinopati ve Etiyopatogenezi. Kocatepe Tıp Dergisi. 2014;15(2):207-17.2. Marshall SM, Flyvbjerg A. Prevention and early detection of vascular complications of diabetes. BMJ : British Medical Journal. 2006;333(7566):475-80.3. Avcı E, Çakır E. Diyabetes Mellitusun Mikrovasküler Komplikasyonu: Diyabetik Nefropati. Selçuk Tıp Dergisi. 2014;30:15-8.4. Kocabora MS, Kocabora AG. Karotis Arter Hastalıklarında Göz Tutulumu. Kocaeli Tıp Dergisi. 2012;1:55-62.5. Retinal Vascular Disease. Diabetic Retinopathy, American Academy of Ophthalmology - Retina and Vitreous - Section 12. 2012-2013. p. 89-112.6. Özmert E. Diabetik Retinopati ve Makülopatinin Tanımı ve Sınıflaması. Ret-Vit. 2014;22:38-45.7. Batıoğlu F. Diabetik Retinopati - Anti-VEGF Tedavi. Ret-Vit. 2014;22:74-8.8. Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. The New England journal of medicine. 1994;331(22):1480-7.9. Murai S, Kusaka N, Umakoshi M, Itami H, Otsuka S, Nishiura T, et al. Stenting for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery Using Proximal Flow Blockade and Distal Protection System: A Technical Case Report and Literature Review. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2016;25(6):e98-e102.10. Li X, Ma X, Lin J, He X, Tian F, Kong D. Severe carotid artery stenosis evaluated by ultrasound is associated with post stroke vascular cognitive impairment. Brain and Behavior. 2017;7(1):e00606.
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Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Case Reports
Authors

Mustafa Suat Alıkma

Erkan Ünsal

Publication Date June 1, 2019
Submission Date July 10, 2018
Acceptance Date September 11, 2018
Published in Issue Year 2019 Volume: 26 Issue: 2

Cite

Vancouver Alıkma MS, Ünsal E. Tek Taraflı Karotis Arter Stenozunda Diabetik Retinopati. Med J SDU. 2019;26(2):205-8.

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