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.

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.

Migrainous infarction of the eye: Two cases of monocular ischemic complications associated with retinal migraine

Cephalalgia ◽  
2021 ◽  
pp. 033310242110562
Author(s):  
Nikita Chhabra ◽  
Chia-Chun Chiang ◽  
Marie A Di Nome ◽  
Odette Houghton ◽  
Rachel E Carlin ◽  
...  
Keyword(s):  
Visual Loss ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Monocular Vision ◽  
Ischemic Optic Neuropathy ◽  
Migrainous Infarction ◽  
Ischemic Complications ◽  
History Of

Background Retinal migraine is defined by fully reversible monocular visual phenomena. We present two cases that were complicated by permanent monocular vision deficits. Cases A 57-year-old man with history of retinal migraine experienced persistent monocular vision loss after one stereotypical retinal migraine, progressing to finger-count vision over 4 days. He developed paracentral acute middle maculopathy that progressed to central retinal artery occlusion. A 27-year-old man with history of retinal migraine presented with persistent right eye superotemporal scotoma after a retinal migraine. Relative afferent pupillary defect and superotemporal visual field defect were noted, consistent with ischemic optic neuropathy. Conclusion Retinal migraine can complicate with permanent monocular visual loss, suggesting potential migrainous infarction of the retina or optic nerve. A thorough cerebrovascular evaluation must be completed, which was unrevealing in our cases. Acute and preventive migraine therapy may be considered in retinal migraine patients, to mitigate rare but potentially permanent visual loss.

scholarly journals Transocular sonography in acute arterial occlusions of the eye in elderly patients: Diagnostic value of the spot sign

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247072
Author(s):  
Michael Czihal ◽  
Christian Lottspeich ◽  
Anton Köhler ◽  
Ilaria Prearo ◽  
Ulrich Hoffmann ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Interobserver Agreement ◽  
Diagnostic Yield ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Diagnostic Value ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Spot Sign ◽  
Retinal Artery

Purpose To characterize the diagnostic yield of the spot sign in the diagnostic workup of acute arterial occlusions of the eye in elderly patients. Methods Clinical characteristics of consecutive patients aged ≥ 50 years with acute central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or anterior ischemic optic neuropathy (AION) were recorded. Videos of transocular sonography were assessed for the presence of the spot sign by two blinded readers. Group comparisons were made between CRAO-patients with and without the spot sign. Two experienced cardiovascular physicians allocated CRAO-cases to a presumed aetiology, without and with knowledge on the presence/absence of the spot sign. Results One-hundred-twenty-three patients were included, 46 of whom suffered from CRAO. A spot sign was seen in 32 of 46 of patients with CRAO and in 7 of 23 patients with BRAO. Interobserver agreement was excellent (Cohen`s kappa 0.98). CRAO-patients with the spot sign significantly more frequently had a medical history of cardiovascular disease (62.8 vs. 21.4%, p = 0.03) and left heart valve pathologies (51.9 vs. 10%, p = 0.03). The spot sign was not found in any of the three patients with CRAO secondary to cranial giant cell arteritis. The assumed CRAO aetiology differed in 37% of cases between two cardiovascular physicians, regardless whether transocular sonography findings were known or not. Conclusion The spot sign is a simple sonographic finding with excellent interobserver agreement, which proofs the embolic nature of CRAO, but does not allow exact attribution of the underlying aetiology.

scholarly journals Perioperative Visual Deficit in a Patient Undergoing Dorsolumbar Spine Surgery

2018 ◽  
Vol 05 (03) ◽  
pp. 195-197 ◽  
Author(s):  
Ved Prakash Pandey ◽  
Arnab Dasgupta ◽  
Anurag Aggarwal ◽  
Sachin Jain
Keyword(s):  
Blood Loss ◽  
General Anesthesia ◽  
Prone Position ◽  
Spine Surgery ◽  
Visual Loss ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Long Duration ◽  
Retinal Artery

AbstractPerioperative visual loss (POVL) is a rare but potentially serious complication of long-duration surgeries in prone position under general anesthesia. The mechanism of visual loss after surgery, and its incidence, is difficult to determine. It is primarily associated with cardiothoracic and spine surgeries. The proposed causes include corneal injury, retinal ischemia (central retinal artery occlusion/branch retinal artery occlusion [CRAO/BRAO]), ischemic optic neuropathy (ION), and cortical blindness. A large, recent multicenter case-control study has identified risk factors associated with ION for patients undergoing spinal instrumentation surgery in prone position. These include male sex, obesity, use of Wilson's frame, long duration of anesthesia/surgery, larger estimated blood loss, and larger relative use of crystalloids for compensation of blood loss. This report describes a relatively healthy, 71-year-old female patient who developed significant visual impairment after thoracolumbar spine surgery in prone position under general anesthesia. The case raises dilemmas regarding the preoperative identification of patients who should be informed of the risk of POVL, and by whom.

Neuro-Ophthalmic Complications of Biopsy-Proven Giant Cell Arteritis

1997 ◽  
Vol 7 (4) ◽  
pp. 375-382 ◽  
Author(s):  
S. Glutz Von Blotzheim ◽  
F.-X. Borruat
Keyword(s):  
Fluorescein Angiography ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Ischemic Optic Neuropathy ◽  
Temporal Artery Biopsy ◽  
Choroidal Ischemia ◽  
Retinal Artery

Purpose To define the spectrum of neuro-ophthalmic complications and clinical presentations of patients with giant cell arteritis (GCA). Methods Retrospective study (1977-1994) of clinical charts, fundus photographies and fluorescein angiographies of 66 patients with temporal artery biopsy positive for GCA. Results Clinical data were adquate for 47 patients. Headaches were reported by 83%, weight loss in 73%, jaw claudication in 68%, scapular pain in 64% and asthenia in 57%. Erythrocyte sedimentation rate was normal in 15%. Neuro-ophthalmic complications were present in 33 cases (70%), including anterior ischemic optic neuropathy (22 cases), choroidal ischemia (17 cases), central or branch retinal artery occlusion (seven cases), and oculomotility disturbances (four cases). Fluorescein angiography was very helpful for detecting choroidal ischemia (80.9% of our cases). Twenty-one patients presented with involvement of several distinct orbital arterial territories and one very unusual patient suffered from an orbital infarction (i.e. ischemia of all orbital structures). Conclusions In our series, two-thirds of biopsy-proven GCA patients presented with neuro-ophthalmic complications, ranging from transient visual loss to orbital infarction. Involvement of more than one orbital vascular territory is highly suggestive of an arteritic process. Clinicians should keep in mind the possibility of GCA even when ESR is normal, and fluorescein angiography should be performed. The finding of choroidal ischemia should prompt temporal artery biopsy and steroid therapy.

Direct carotid puncture for endovascular thrombectomy in acute ischemic stroke

2019 ◽  
Vol 11 (7) ◽  
pp. 647-652 ◽  
Author(s):  
Adam Roche ◽  
Emma Griffin ◽  
Seamus Looby ◽  
Paul Brennan ◽  
Alan O’Hare ◽  
...  
Keyword(s):  
Central Retinal Artery Occlusion ◽  
Case Series ◽  
Intravenous Thrombolysis ◽  
Standard Of Care ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Anterior Circulation ◽  
Arterial Access ◽  
Femoral Approach ◽  
Access Complications

BackgroundMechanical thrombectomy is the standard of care for acute ischemic strokes with proximal intracranial occlusion. Arterial access is commonly achieved with femoral artery puncture, although this is not always possible. In this case series, we describe 11 cases of anterior circulation stroke where direct carotid puncture was used to obtain vascular access.Methods and materialsA review of a prospectively maintained thrombectomy database over a 2-year period (August 2016 – August 2018) was undertaken to identify cases where direct carotid access was performed. CT and angiographic imaging were reviewed. Indications for carotid access, techniques used, technical success of procedure, recanalization rates, procedure-related complications, and patient outcomes were assessed.ResultsEleven patients out of 498 overall thrombectomy procedures (2.2% thrombectomies) underwent direct carotid access. Median National Institutes of Health Stroke Scale was 20. Seventy three percent of patients received intravenous thrombolysis. The direct carotid approach was performed following the failed femoral approach due to unfavorable aortic arch anatomy, vessel tortuosity, and severe atherosclerotic disease. Direct carotid puncture was successful in 10 patients, and unsuccessful in one. Successful recanalization (TICI 2b–3) was achieved in eight patients. One patient had spontaneously recanalized on angiography. There was failed recanalization in one patient with tandem ICA and M1 occlusion. Carotid access complications included one patient with both neck hematoma and asymptomatic ICA dissection, and one of delayed central retinal artery occlusion.ConclusionThis case series highlights direct carotid puncture as a successful alternative when the femoral approach is not possible, allowing thrombectomy in patients who would otherwise be unsuitable.

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