Oculoplethysmography and supraorbital Doppler evaluation of carotid disease. A reappraisal

A variety of noninvasive tests are available for the evaluation of patients with suspected extracranial cerebrovascular disease. Recent emphasis on more sophisticated techniques has raised questions concerning the current utility of older methods, e.g., pulse delay oculoplethysmography (OPG) and supraorbital Doppler (SOD) examination. The results of OPG and SOD examination were compared with the findings of carotid arteriography in 75 consecutive patients. This analysis revealed a sensitivity of 78 per cent, specificity of 92 per cent, false-positive rate of 12.5 per cent, false-negative rate of 15.8 per cent, and overall diagnostic accuracy of 85 per cent for OPG. Although the specificity of SOD was superior (94.3%), the sensitivity (41%) false-positive rate (16.6%), false-negative rate (30.5%), and overall diagnostic accuracy of 71.6 per cent of SOD revealed it to be an inferior test of significant carotid stenosis. Based on its ease of performance, minimum of time required, and high level of diagnostic accuracy, OPG currently remains a valuable screening procedure for carotid disease, particularly in the asymptomatic bruit population.