M Hussain, R Malik, M Zaman, TF Babar, SM Elsherbiny, LP Lip


Background: The Carotid Artery Insufficiency Retinopathy (CAIR) is an uncommon sign of carotid
artery obstruction. It is mainly found in patients with complete occlusion or severe obstruction of
Internal Carotid Artery (ICA). Retinopathy is caused by progressive and chronic hypoxia to ocular
tissues. The purpose of the study is to describe the variable presentation of CAIR in patients with
internal carotid artery stenosis and to asses the resolution of retinopathy in patients who had carotid
endarterectomy. Methods: Records of the patients with confirmed internal carotid artery stenosis
were reviewed. Patients’ demographic data and way of presentation to ophthalmologist was
recorded. Associated systemic vascular diseases were also recorded on the proforma. Records of the
patients with confirmed internal carotid artery stenosis were reviewed. Results: Thirteen eyes of 10
patients were included in study with male to female ratio of 9:1. Patients’ clinical presentation
ranged from scattered blot haemorrhages to ocular ischemic syndrome. Patients presented with
retinopathy at different stages. The presentation of retinopathy varied from scattered blot
haemorrhages to ocular ischemic syndrome. Endarterectomy resolved CAIR in 2 out of 3 patients,
with one patient having bilateral resolution. Conclusion: CAIR should be suspected if retinopathy is
unilateral. On the other hand patients with asymptomatic Carotid artery stenosis should be examined
for signs of ocular ischemia. All patients with CAIR should be investigated for cardiovascular
diseases. Endarterectomy in selected patients can resolve CAIR.
Keywords: Carotid artery insufficiency retinopathy (CAIR), Internal carotid artery (ICA),

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