256110 Ocular morbidities associated with carotid occlusive disease in a veteran population

Monday, October 29, 2012

Charles Davis Jr., OD, MPH, MHA , 'Bill Hefner' Salisbury Veteran Affairs Medical Center (Eye Clinic), Department of Veteran Affairs, Salisbury, NC
Frank Labagnara, DO , 'Bill Hefner' Salisbury Veteran Affairs Medical Center (Primary Care), Department of Veteran Affairs, Salisbury, NC
Gerald Pyle, PhD , Department of Public Health Sciences, University of North Carolina- Charlotte, Matthews, NC
Stroke continues to be a leading cause for morbidity and mortality in the United States. A significant number of strokes are related to carotid occlusive disease, and approximately 30% of ischemic infarctions are associated with carotid artery stenosis. Eye care professionals are familiar with ocular signs and symptoms of carotid occlusive disease (COD), but few studies have investigated ocular morbidities related to carotid occlusive disease. Our study is designed as a retrospective, case-control analysis, of Veterans referred for duplex carotid ultrasonography with suspect carotid occlusive disease (COD). All Veterans had comprehensive eye examinations and duplex carotid ultrasonography prior to data extraction. This study was reviewed and approved by the Salisbury Veteran Affairs Medical Center (VAMC) Institutional Review Board (IRB) and the Salisbury VAMC Privacy Officer. Case subjects were defined as 50% or greater carotid stenosis, and control subjects were defined as less than 50% stenosis. A total of 400 eligible subjects, 250 controls and 150 cases, were identified for data extraction. Data for twelve ocular variables were extracted from the medical records. Odds ratios were calculated for these variables and hypothesis testing was conducted. Our analysis indicates that case subjects were significantly more likely to have reduced acuities and a diagnosis for ocular disease (glaucoma, macular degeneration, cataract, diabetic retinopathy, retinal vascular occlusion) compared to control subjects. These findings have real implications regarding the role of chronic disease management related to prevention of vision loss in an aging population.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health

Learning Objectives:
1. Identify five ocular morbidities associated with carotid occlusive disease. 2. List four clinical, ocular signs associated with carotid occlusive disease. 3. Discuss health strategies that promote healthy vision, and reduce risk related to carotid occlusive disease.

Keywords: Vision Care, Veterans' Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over ten years clinical experience in hospital based vision care, and have served as principal investigator on multiple, IRB approved, vision related research projects. Previously, I served as Director of Clinical Researach at the Northeastern State University, College of Optometery.In addition, I served for six years as the Chair of the Salisbury VAMC IRB. One of my specific interests is on the relationship between vision and systemic disease.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3098.0: Vision and Aging