scholarly journals Clinical Characteristics of Paracentral Acute Middle Maculopathy in Eyes with Retinal Vascular Occlusion Diseases in Chinese Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zhengwei Zhang ◽  
Yunjia Jiang ◽  
Xiaoli Huang ◽  
Zhifeng Wu ◽  
Bilian Ke
Keyword(s):  
Clinical Characteristics ◽  
Vascular Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Chinese Patients ◽  
Fundus Photography ◽  
Fluorescence Angiography ◽  
Imaging Data ◽  
Interesting Phenomenon ◽  
Retinal Vascular Occlusion

Aim. To investigate the incidence and clinical characteristics of paracentral acute middle maculopathy (PAMM) and its relationship with prominent middle limiting membrane (p-MLM) sign in eyes with retinal artery occlusion (RAO) or retinal vein occlusion (RVO) in a Chinese clinical setting. Methods. In this retrospective observational study from January 2015 to May 2020, multimodal imaging data of 807 eyes including 555 consecutive patients with RVO or 252 consecutive patients with RAO were reviewed. All patients were scanned using the spectrum-domain optical coherence tomography (OCT), and some of them underwent color fundus photography, fundus fluorescence angiography, en face OCT, and OCT angiography. Results. PAMM was detected in 49 eyes of 49 RAO patients and 29 eyes of 29 RVO patients. The mean ages at presentation were 64.49 ± 13.90 years and 54.00 ± 18.48 years in RAO and RVO patients ( P = 0.006 ), respectively. Eyes with RAO were more prone to develop PAMM (19.44% [49/252] vs. 5.23% [29/555]; P < 0.001 ). Of the 78 eyes with PAMM, 24 eyes (7 eyes with RVO and 17 eyes with RAO) were found with p-MLM sign. An interesting phenomenon that had been overlooked before was that the hyperreflective line of the p-MLM sign was usually continuous, regardless of the type of PAMM lesion. Conclusions. This series is the largest to date to describe the clinical characteristics of PAMM and p-MLM sign in Chinese patients. The incidence of PAMM and p-MLM sign in patients with RAO was relatively higher than that in patients with RVO. These signs alone probably represent milder ischemia and prompt us to carry out a comprehensive and meticulous examination to prevent the further development of the disease. In addition, the hyperreflective line of the p-MLM sign was usually continuous, which could support the totally venous nature of the retinal deep capillary plexus to some extent.

OCT based interpretation of the optic nerve head anatomy in young adults with retinal vascular occlusions and ischemic optic neuropathy

2020 ◽  
pp. 112067212095759
Author(s):  
Amy Dai ◽  
Lasse Malmqvist ◽  
Simon P Rothenbuehler ◽  
Steffen Hamann
Keyword(s):  
Young Adults ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Vascular Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Vein Occlusion ◽  
Retinal Vascular Occlusion ◽  
Retinal Artery

Purpose: To examine optic nerve head (ONH) anatomy in young adults with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or nonarteritic anterior ischemic optic neuropathy (NA-AION) in order to look for associated, potentially predisposing anomalies. Methods: Cross-sectional study including 54 patients (ages 16–50 years) diagnosed from 2009 to 2018 with CRVO, BRVO, CRAO, BRAO, or NA-AION. Using Optical Coherence Tomography the presence of optic disc drusen (ODD), prelaminar hyperreflective lines and peripapillary hyperreflective ovoid mass-like structures (PHOMS), and determination of scleral canal size, retinal nerve fiber layer thickness (RNFLT) and macular ganglion cell layer thickness (GCLT) was obtained. Data for retinal vascular occlusion patients were grouped and analyzed together. Results: ODD were found in 13% of all patients, 2% of retinal vascular occlusion patients and 67% of NA-AION patients ( p < 0.0001). Prelaminar hyperreflective lines were found in 35% of all patients, 24% of retinal vascular occlusion patients and 89% of NA-AION patients ( p = 0.0005). PHOMS were found in 20% of all patients, 13% of retinal vascular occlusion patients and 56% of NA-AION patients ( p = 0.012). RNFLT was decreased in ODD patients compared to patients without ODD ( p = 0.01). Scleral canal diameter and GCLT was not correlated with ODD, prelaminar hyperreflective lines or PHOMS. Conclusion: ODD, prelaminar hyperreflective lines and PHOMS were more frequent in NA-AION patients compared to retinal vascular occlusion patients. The prevalence of ODD in retinal vascular occlusion patients was similar to the reported prevalence in the general population.

Cerebral angiographic features of central retinal artery occlusion patients treated with intra-arterial thrombolysis

2021 ◽  
pp. neurintsurg-2021-017767
Author(s):  
Jongshin Kim ◽  
Seunguk Jung ◽  
Kyu Hyung Park ◽  
Se Joon Woo ◽  
Cheolkyu Jung
Keyword(s):  
Central Retinal Artery Occlusion ◽  
Visual Outcome ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Fundus Photography ◽  
Early Reperfusion ◽  
Atherosclerotic Lesions ◽  
Retinal Artery ◽  
Arterial Thrombolysis

BackgroundCentral retinal artery occlusion (CRAO) is an ischemic stroke of the eye. The atherosclerotic lesions in the intracranial segment of the carotid artery (CA) and the ophthalmic artery (OphA) are not well defined. We aimed to investigate the cerebral angiographic features of CRAO patients and assess the relationship between the angiographic features and outcomes after intra-arterial thrombolysis (IAT).MethodsWe included 101 acute non-arteritic CRAO patients treated with IAT. We analyzed the detailed angiographic features of the OphA and ipsilateral CA, visual acuity, fundus photography, and fluorescein angiography.ResultsOf the 101 patients, 38 patients (37.6%) had steno-occlusive lesions in the OphA, and 62 patients (61.4%) had atherosclerotic lesions in the ipsilateral CA. The patients with a higher degree of stenosis in the OphA showed a higher degree of stenosis (P=0.049) and a more severe morphology of plaque (P=0.000) in the ipsilateral CA. Additionally, although the visual outcome was not associated with these angiographic features, the lower degree of stenosis and less severe morphology of plaque in the ipsilateral CA resulted in a significant improvement in early reperfusion rate (P=0.018 and P=0.014, respectively) and arm-to-retina circulation (P=0.016 and P=0.002, respectively) of the eye after IAT.ConclusionsThere was a significant correlation in the severity of steno-occlusive lesions between the OphA and the ipsilateral CA in patients with CRAO. The patients with less severe angiographic features in the CA showed a more improved retinal reperfusion after IAT. The angiographic findings in the CA may serve as a predictive marker for the vessel integrity of the OphA and recanalization outcome after IAT.

Isolated cilioretinal artery occlusion secondary to perinuclear antineutrophil cytoplasmic antibody vasculitis

2019 ◽  
Vol 30 (5) ◽  
pp. NP53-NP57
Author(s):  
Danny A Mammo ◽  
Collin M McClelland ◽  
John Chen ◽  
Matthew K Adams ◽  
Jose Pulido ◽  
...  
Keyword(s):  
Vascular Occlusion ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Artery Occlusion ◽  
Small Vessel Vasculitis ◽  
Retrospective Case ◽  
Ocular Manifestations ◽  
Retinal Vascular Occlusion ◽  
Cilioretinal Artery Occlusion ◽  
Cilioretinal Artery ◽  
Retrospective Case Study

Introduction: Antineutrophil cytoplasm antibody-associated vasculitides encompass a diverse spectrum of autoimmune diseases characterized by necrotizing small vessel vasculitis. Ocular manifestations may be the presenting findings of antineutrophil cytoplasm antibody-associated vasculitides. Methods: Single, retrospective case study. Results: We report the rare case of a 55-year-old woman with a cilioretinal artery occlusion as the presenting feature of perinuclear antineutrophil cytoplasm antibody-associated microscopic polyangiitis. Conclusions: Although rare, antineutrophil cytoplasm antibody-related vasculitis should be considered in any retinal vascular occlusion, particularly in the setting of patients with new vague headaches and a paucity of vasculopathic risk factors.

The association of aldosterone with papillophlebitis and retinal artery occlusion: A case report

2021 ◽  
pp. 112067212199139
Author(s):  
Che-Yuan Kuo ◽  
Po-Kang Lin
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Retinal Artery Occlusion ◽  
Pulse Therapy ◽  
Artery Occlusion ◽  
Steroid Pulse Therapy ◽  
Steroid Pulse ◽  
Retinal Vascular Occlusion ◽  
Retinal Artery ◽  
The Right

Purpose: To explore the association between elevated blood aldosterone levels and papillophlebitis and retinal artery occlusion in a young, healthy woman. Case description: A 19-year-old woman with an unremarkable medical history presented with sudden-onset visual loss in the right eye, which lasted for 10 hours. Fundus examination revealed retinal whitening, splinter hemorrhages, disc swelling, and tortuous vessels in the right eye. Optical coherence tomography revealed inner retinal thickening. Fluorescein angiography demonstrated a delayed arteriovenous transit time and delayed filling of the cilioretinal artery circulation. Further workup showed a high aldosterone level and aldosterone-to-renin ratio. The patient was treated with steroid pulse therapy and combined intravitreal injection of dexamethasone implant and aflibercept. Visual acuity was recovered from count finger at initial presentation to 6/15 on the fifth day. For over 2 months, the fundal manifestations gradually subsided. Three months after the episode, her visual acuity further improved to 6/6.7. Conclusion: This report emphasizes the potential role aldosterone plays in the complex disease mechanism of retinal vasculopathy. In addition, steroid pulse therapy is more effective when applied in conjunction with combined intravitreal injection therapy for rescuing impaired vision caused by retinal vascular occlusion.

scholarly journals Complications of Intra-Arterial tPA for Iatrogenic Branch Retinal Artery Occlusion: A Case Report through Multimodal Imaging and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 963
Author(s):  
Katherine Dalzotto ◽  
Paige Richards ◽  
Tyler D. Boulter ◽  
Marilyn Kay ◽  
Mihai Mititelu
Keyword(s):  
Visual Field ◽  
Multimodal Imaging ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Fundus Photography ◽  
Automated Perimetry ◽  
Branch Retinal Artery Occlusion ◽  
Retinal Artery ◽  
Sd Oct

Background and Objectives: To document, through multimodal imaging, the post-procedural clinical course and visual outcome of a patient who received intra-arterial tissue plasminogen activator (tPA) for acute iatrogenic branch retinal artery occlusion (BRAO), and to review the literature and guidelines regarding the use of tPA for retinal arterial occlusions. Methods: A 28-year-old female patient who sustained an iatrogenic BRAO and subsequently received intra-arterial tPA was followed through her post-interventional course of 3 months with serial exams and multimodal imaging, including color fundus photography, visual field testing, spectral domain optical coherence tomography (SD-OCT), and OCT angiography (OCT-A). Results: A patient with history of left internal cerebral artery (ICA) aneurysm and baseline visual acuity (VA) of 20/20 developed an acutely symptomatic BRAO after undergoing a neuroendovascular procedure and was acutely treated with tPA through the left ophthalmic artery. At two weeks follow-up, a central posterior pole hemorrhage was noted although VA was preserved. A superior altitudinal defect was shown on automated perimetry. VA dropped to 20/50 at 7 weeks follow-up and hyperreflective material deep to the attachment between the posterior hyaloid and the internal limiting membrane (ILM) consistent with hemorrhage was noted on SD-OCT. At 11 weeks follow-up, VA returned to 20/20, SD-OCT revealed a membrane bridging the foveal depression, OCT-A showed decreased vascularity in the inferior macula, and the visual field defect was stable by automated perimetry. Conclusions: Intraocular hemorrhage is a possible complication of intra-arterial tPA administration for BRAO, and a careful analysis of risks, benefits, and goals of this procedure must be considered by both provider and patient before such intervention.

scholarly journals Central Retinal Artery Occlusion Associated with Varicella dermatitis

2016 ◽  
Vol 36 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Rajan Kumar Labh ◽  
Rahul Choubey ◽  
Bimal Agrawal
Keyword(s):  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
The Body ◽  
Central Retinal Artery ◽  
Fluorescence Angiography ◽  
Fundus Examination ◽  
Varicella Infection ◽  
Antibody Assay ◽  
Retinal Artery

A 12 year girl presented with left eye (LE) loss of vision for four days. Fundus examination and fluorescence angiography revealed LE central retinal artery occlusion (CRAO). She had multiple rashes all over the body. IgM-Varicella antibody assay corresponded with varicella infection and she was diagnosed with CRAO associated with varicella dermatitis.J Nepal Paediatr Soc 2016;36(1):78-81.

scholarly journals Retinal artery occlusion as a probable idiosyncratic reaction to topical minoxidil: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ramesh Venkatesh ◽  
Arpitha Pereira ◽  
Nikitha Gurram Reddy ◽  
Naresh Kumar Yadav
Keyword(s):  
Anterior Segment ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Mantoux Test ◽  
Androgenic Alopecia ◽  
Idiosyncratic Reaction ◽  
Retinal Vascular Occlusion ◽  
Topical Minoxidil ◽  
Retinal Artery

Abstract Background Minoxidil hair formulation is commonly used for the treatment of male or female androgenic alopecia. This over-the-counter product is considered safe, but should be used with caution. Ocular side effects following topical minoxidil use are rarely reported. In this paper, we report a rare case of inferior hemiretinal artery occlusion possibly caused by topical 5% minoxidil treatment. Case description A 21-year-old Asian Indian male presented to the retina clinic with sudden onset blurring of vision and superior visual field loss in the right eye since morning. He was diagnosed with androgenic alopecia and was on treatment with topical 5% minoxidil spray twice a day for the last 3 years. On examination, his corrected distance visual acuity was 6/6, N6 in both eyes. Anterior segment examination and intraocular pressure in both eyes and left eye fundus were within normal limits. Right eye fundus examination showed features suggestive of inferior hemiretinal artery occlusion, which were confirmed on fluorescein angiography and optical coherence tomography. A detailed systemic evaluation and investigations (blood pressure, random blood sugar, hematological and coagulation profile, serum homocysteine level, Mantoux test, chest x-ray, cardiac two-dimensional echography, thyroid function test, and immunological profile) did not detect any abnormalities. The ocular condition and its visual prognosis were explained to the patient, and he was asked to review after 4 weeks. Conclusion Though there is no definite cause–outcome relationship between topical minoxidil use and retinal artery occlusion development, this possibility should be kept in mind when observing retinal vascular occlusion cases with concurrent use of topical minoxidil.

scholarly journals The Use of Vitamins and Coenzyme Q10 for the Treatment of Vascular Occlusion Diseases Affecting the Retina

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 723 ◽  
Author(s):  
Beatriz Fernández-Vega ◽  
Javier Nicieza ◽  
Ana Álvarez-Barrios ◽  
Lydia Álvarez ◽  
Montserrat García ◽  
...  
Keyword(s):  
Coenzyme Q10 ◽  
Case Series ◽  
Vascular Diseases ◽  
Vascular Occlusion ◽  
Retinal Artery Occlusion ◽  
Nutritional Supplement ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Beneficial Effects ◽  
Case Series Study

Nutritional supplementation with antioxidants and vitamins is widely recommended in the treatment of vascular disorders affecting the retina, although there is insufficient evidence on its effectiveness. The vitamin-like compound coenzyme Q10 (CoQ10) is a nutritional supplement of current interest to treat neurodegenerative diseases. Here, we report a retrospective clinical case series study of 48 patients diagnosed with retinal vascular diseases, including non-arteritic ischemic optic neuropathy (NAION), retinal artery occlusion (RAO), and homonymous hemianopia or quadrantanopia following stroke, treated with oral supplementation with CoQ10 (100 mg per day) and vitamins. Patient follow-up was performed using the Humphrey field analyzer and 30-2 testing algorithm to determine the visual field index (VFI) and progression rates. All treated patients showed positive VFI progression rates per year: +11.5 ± 15% for NAION patients (n = 18), +22 ± 17% for RAO patients (n = 7), +9.3 ± 10.5% for hemianopia/quadrantanopia patients (n = 10), and +11 ± 21% for patients with other conditions (n = 13). The interruption of CoQ10 supplementation in one patient resulted in a pronounced decrease of the VFI, which was partially recovered when treatment was restored. This study supports the role of CoQ10 as a nutritional therapeutic agent for vascular diseases affecting the retina. Owing to decreased VFI after interruption of CoQ10, its beneficial effects may be reversible.

Sign in / Sign up

Export Citation Format

Share Document