Vascular Retinal Event Secondary to Ocular Ischemic Syndrome, Improved With QIAPI 1: Case Report

Abstract

Ocular ischemic syndrome (OIS) is a rare condition, which is caused by ocular hypoperfusion due to
stenosis or occlusion of the common or internal carotid arteries. Atherosclerosis is the major cause of
changes in the carotid arteries.
Since OIS is associated with atherosclerosis, patients usually have other related co-morbidities.
Hypertension is found in 73% of the patients and diabetes mellitus in 56%. The first case of OIS was
reported in 1963 by Hedges as a case with retinal hemorrhages and venous dilatation in a patient with
complete occlusion of the internal carotid artery (ICA). The only therapy is to treat the neovascular
complications.
Recent studies suggest that OIS is associated with a significant risk of cerebrovascular, ocular, and
systemic morbidity. OIS has a poor visual prognosis. It is imperative that the clinician be aware of the
signs and symptoms of carotid disease to facilitate prompt diagnosis and appropriate referral, because
OIS may be the presenting sign of serious ischemic cerebrovascular and ischemic heart disease. The
5-year mortality rate in OIS patients is as high as 40%. Most deaths are due to cardiac disease
Controversy in the management of OIS arises from the fact that most patients reported in the literature
are part of small retrospective series or case reports. Besides the uncertainty about the physio-pathogenic
of the disease. Pan-retinal photocoagulation (PRP) is the accepted treatment for retinal ischemia
predisposing to neovascularization due to retinal ischemia supposedly triggers the production of
angiogenic growth factors. However, the main stimulus to abnormal angiogenesis is hypoxia more than
ischemia, and opposite the best antiangiogenic factor is high levels of oxygen in tissues.
Thereby, our discovery about the unexpected capacity of several organic molecules of the human body
that can take the oxygen from intracellular water, like in plants, open a new way to treat these difficult
cases, improving the prognosis.