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What is a Transcranial Doppler scan?
Transcranial Doppler
A Transcranial Doppler (TCD) is a fifteen-minute, non-invasivepainless, extremely safe ultrasound test which looks at all of the major arteries and vessels of the Circle of Willis. This allowsfor the assessment of a patient’s risk of stroke/ocular stroke bymeasuring the ophthalmic artery and cerebral vascular blood flow.
A TCD is effective for diagnosin emboli, stenosis, vasospasm from a subarachnoid hemorrhage (bleeding from a ruptured aneurysm), and other problems. It can also detect sickle cell disease, ischemic cerebrovascular disease, subarachnoid hemorrhage, arteriovenous malformations, and cerebral circulatory arrest.
How can Transcranial Doppler help Retinal Ischemic AMD Patients
Retinal Ischemic AMD Patients
PI and RI in patients with AMD were significantly
higher and increased monotonically with the severity
of AMD.
Reduced Systemic Arterial Circulation affects retinal
ischemia and is associated with the increasing severity
of AMD.
Doppler Imaging demonstrates reduced or reversed
blood flow in the ophthalmic artery which directly
affects the blood supply to the choroid, retina, and
posterior ciliary arteries, thus causing chronic
ischemia to the Bruch’s membrane.
Retinal Specialist TCD Indications
Retinal OCT Diagnosis Corresponding ICD 10 Codes
- AMD
- Retinal Ischemia
- Diabetic Retinopathy
- Hypertensive Retinopathy
- Macular Edema
- Retinal Ischemia H35.82
- Venous Engorgement H34.823
- CRVO H34.813
- CRAO H34.13
- Tributary Vein Occlusion H34.83
- Partial Arterial Occlusion H34.213
- Transient Arterial Occlusion H34.03
- Arterial Branch Occlusion H34.23
Role Of Transcranial Doppler in Diabetic Retinopathy
Diabetic Retinopathy
Diabetic Retinopathy
PDR patients have a significantly higher PI (pulsatility
index) and lower cerebrovascular reactivity than
NPDR patients, suggestive of a silent cerebral
microangiopathy
Patients with Proliferative Diabetic Retinopathy
demonstrate abnormal hemodynamic responses of
the cerebral and ophthalmic circulation [1]
Retinal Vein Occlusion and Risk Of Stroke Development
Retinal Vein Occlusion and the Risk of Stroke
Development
A 9-Year Nationwide Population-Based study
PAGES 1, 2,
PAGES 3, 4,
PAGES 5, 6
PAGES 7, 8
6 months of 8 General Ophthalmology Practices
Testing Follow-Up Protocol
- Positive tests: Documented phone call to patient/
family member
- Verify identity of PCP and any Cardiologist
- Test result and Personalized Cover Letter sent to PCP/
- Cardiologist (integrated into EMR)
- Follow up phone calls per PCP/ Cardiology/ patient
request
- Test result scanned into EMR
Breakdown of Systemic Medication of Patients with Positive Pathology
Total: 2781/8903= 31.25% Positive