EMBOLUS-INDUCED BRANCH RETINAL ARTERY OCCLUSION WITH A PRESENTING BEST-CORRECTED VISUAL ACUITY OF <6/12 AND VISUAL FIELD DEFECT

2013 ◽  
Vol 7 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Tsui-Kang Hsu ◽  
Shih-Jen Chen ◽  
Jianqin Lei ◽  
Zhifeng Wu ◽  
Chih-Ching Lin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Field Defect ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Corrected Visual Acuity ◽  
Retinal Artery ◽  
Field Defect ◽  
Best Corrected Visual Acuity

A Young Man With Visual Field Loss, Decreased Hearing, and Confusion

2021 ◽  
pp. 168-170
Author(s):  
M. Tariq Bhatti ◽  
Eric R. Eggenberger ◽  
Marie D. Acierno ◽  
John J. Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Field ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Susac Syndrome ◽  
Retinal Artery ◽  
Signal Changes ◽  
The Brain ◽  
Field Defect

A 27-year-old man noted imbalance and staggering when walking. Vertigo, nausea, vomiting, and mild fever developed. This was presumed to be due to an inner ear infection, and antibiotics were prescribed. He began experiencing intermittent left face and arm numbness, bilateral hearing loss and tinnitus. Audiography indicated low-frequency hearing loss in both ears, left worse than right. He reported headaches and neck stiffness, and his family noticed that he was moody, easily aggravated, and confused, with slow mentation. Magnetic resonance imaging showed patchy, nodular, leptomeningeal enhancement involving both cerebral hemispheres and the posterior fossa, with scattered hyperintense T2 signal changes of the internal capsule and prominent abnormal signal changes in the corpus callosum. Cerebrospinal fluid analysis was remarkable for a markedly increased protein concentration and white blood cells. Eye examination showed 20/20 vision in both eyes with a superior visual field defect in the right eye. Retinal whitening was noted in the vascular distribution of the inferotemporal arcade. Intravenous fluorescein angiography showed delayed filling in this region consistent with a branch retinal artery occlusion and scattered areas of arteriolar wall hyperfluorescence. A diagnosis of Susac syndrome was made on the basis of the branch retinal artery occlusion, magnetic resonance imaging findings, and hearing deficit. Intravenous methylprednisolone was given, followed oral prednisone, which resulted in substantial improvement in headaches and cognition. Cyclophosphamide was also started at the same time as intravenous methylprednisolone. A new visual field defect developed due to a branch retinal artery occlusion in the left eye, which prompted initiation of intravenous immunoglobulin and transition from cyclophosphamide to rituximab. He had no recurrent branch retinal artery occlusions or other relapses of his underlying Susac syndrome on this treatment regimen. Susac syndrome was initially described as a microangiopathy of the brain and retina. It is an idiopathic autoimmune disorder that primarily affects the brain, eye, and inner ear.

scholarly journals Branch Retinal Artery Occlusion after Percutaneous Coronary Intervention

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Tommaso La Macchia ◽  
Remo Albiero ◽  
Tommaso Invernizzi ◽  
Giorgia Ceravolo ◽  
Ida Ceravolo
Keyword(s):  
Visual Acuity ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Care Providers ◽  
Systemic Complications ◽  
Percutaneous Coronary ◽  
Retinal Artery

We report a case of branch retinal artery occlusion (BRAO) that occurred after percutaneous coronary intervention (PCI). A 59-year-old man with no other previous diseases presented visual acuity deterioration in the left eye 24 hours after PCI. Fundus examination revealed ischemia at the temporal branch of the retinal artery associated with inner layer edema. Prompt treatment was performed with ocular digital massage and paracentesis of the anterior chamber. However, at discharge, the patient had a persistent visual loss with a central scotoma that persisted at 35-day follow-up without improvement of the visual acuity. The patient did not suffer from any other systemic complications. Retinal infarction should be considered a potential complication of PCI. Patients and health care providers should be aware of any visual signs. Permanent visual disability can be prevented by immediate diagnosis and prompt intervention.

scholarly journals Dexamethasone Implant (Ozurdex) in a Case with Unilateral Simultaneous Central Retinal Vein and Branch Retinal Artery Occlusion

2015 ◽  
Vol 6 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Taylan Ozturk ◽  
Omer Takes ◽  
A. Osman Saatci
Keyword(s):  
Visual Acuity ◽  
Rare Condition ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Dexamethasone Intravitreal Implant ◽  
Severe Visual Loss ◽  
Intravitreal Implant ◽  
Retinal Artery ◽  
Central Retinal Vein

Simultaneous branch retinal artery and vein occlusion is a rare condition that may cause severe visual loss, and its treatment is often unrewarding. Herein, we report a case with simultaneous central retinal vein and branch retinal artery occlusion; it was successfully treated with a single dexamethasone intravitreal implant. The affected eye attained a visual acuity level of 20/25 from the visual acuity of hand motions at presentation with a residual, but relatively diminished, altitudinal scotoma during a follow-up period of 6 months.

scholarly journals Hyperbaric Oxygen Therapy in Branch Retinal Artery Occlusion in a 15-Year-Old Boy with Methylenetetrahydrofolate Reductase Mutation

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Ali Riza Cenk Celebi ◽  
Sibel Kadayifcilar ◽  
Bora Eldem
Keyword(s):  
Visual Acuity ◽  
Hyperbaric Oxygen ◽  
Methylenetetrahydrofolate Reductase ◽  
Visual Fields ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Laboratory Evaluation ◽  
Branch Retinal Artery Occlusion ◽  
Fundus Fluorescein Angiography ◽  
Retinal Artery

Purpose.To report the efficacy of hyperbaric oxygen (HBO) therapy in a case of branch retinal artery occlusion (BRAO) in a 15-year-old boy.Methods.We report a 15-year-old boy with sudden loss of vision due to BRAO. Examination included laboratory evaluation for systemic risk factors. Follow-up exams included visual acuity, fundus examination, fundus fluorescein angiography, and visual field testing. HBO therapy was employed for treatment.Results.Medical history was positive for isolated glucocorticoid deficiency. Laboratory evaluation disclosed hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR) mutation. The visual acuity 0.05 at presentation improved to 0.8 after 20 days of HBO therapy. There was no change on visual fields.Conclusion.In this pediatric case, HBO therapy was useful in the treatment of BRAO.

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 Delayed Vision Recovery after Carotid Vascular Surgery for Branch Retinal Artery Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Jessica Ruzicki ◽  
Eric K. Chin ◽  
David Almeida
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Visual Field ◽  
Carotid Artery ◽  
Visual Field Loss ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Carotid Artery Endarterectomy ◽  
Retinal Artery

Branch retinal artery occlusion (BRAO) is typically associated with irreversible vision and peripheral visual field loss. We report a case of a 62-year-old woman with a BRAO related to several cardiovascular risk factors. Our patient encountered gradual but significant vision recovery months following carotid artery endarterectomy for carotid stenosis.

scholarly journals The hyporeflective fern-like pattern on deep-layer en face images of acute central retinal artery occlusion

2019 ◽  
Author(s):  
Junki Hoshino ◽  
Hideo Akiyama ◽  
Mikiya Magori ◽  
Ryo Mukai ◽  
Hidetaka Matsumoto
Keyword(s):  
Visual Acuity ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Swept Source ◽  
Face Images ◽  
Corrected Visual Acuity ◽  
En Face ◽  
Group A ◽  
Retinal Artery

Abstract Background We examined B-mode and en face images of swept-source optical coherence tomography (SS-OCT) from patients with central retinal artery occlusion (CRAO), and investigated associations between their characteristics and prognosis for visual acuity. Methods We retrospectively investigated 11 eyes in 11 patients with CRAO who underwent swept-source OCTA (PLEX Elite 9000®; Carl Zeiss, Dublin, California, USA) and SS-OCT (DRI OCT-1 Atlantis, Topcon, Tokyo, Japan) at the acute phase and 1 month after onset. Results Fern-like hyporeflective patterns aligned with the superficial arterioles were observed in acute-phase deep-layer en face images from 4 patients. Patients who exhibited these hyporeflective fern-like patterns were categorized as Group A, and all other patients as Group B. No significant difference in best-corrected visual acuity at initial examination was seen between the groups. At one month after onset, best-corrected visual acuity was significantly better in Group A, and retinal thinning also tended to be milder. Conclusions Our results indicate that a hyporeflective fern-like pattern in acute CRAO may suggest good prognosis.

scholarly journals Intraoperative Cycling Pressure Variation in the Treatment of Central Retinal Artery Occlusion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Pars Plana Vitrectomy ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Pressure Variation ◽  
Central Retinal Artery ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
Retinal Artery ◽  
Best Corrected Visual Acuity

A 45-year-old male presented to the clinic of ophthalmology with central retinal artery occlusion (CRAO). There was no response to medical treatment, ocular massage, and anterior chamber paracentesis. CRAO was resolved by pars plana vitrectomy and intraoperative cycling pressure variation. The best-corrected visual acuity improved to 20/100 on the first day and to 20/20 on the first month, postoperatively.

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