Transient central retina artery occlusion in patients undergone intravitreal anti-vascular endothelial growth factor injections

2021 ◽  
pp. 112067212110661
Author(s):  
Nadyr A Damasceno ◽  
Nicolas A Yannuzzi ◽  
Mauricio Maia ◽  
Michel Eid Farah ◽  
Harry W Flynn ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Vascular Endothelial ◽  
Plaque Size ◽  
Atheroma Plaque ◽  
Retinal Artery ◽  
Endothelial Growth Factor

Purpose To evaluate the occurrence of transient central retinal artery occlusion following intravitreal anti-vascular endothelial growth factor injection. Methods Prospective, observational study of 807 patients (807 eyes) who were given intravitreal injections of ranibizumab or aflibercept to treat any cause of retinal vascular diseases between 1 January 2017 and 30 November 2018 at the Federal Fluminense University Hospital in Niteroi, and a private facility in Rio de Janeiro, Brazil. Patients who did not present transient central retinal artery occlusion were excluded. Results Among 4069 injections, only 18 patients (0.44%) presented transient central retinal artery occlusion, 14 mild cases (77.7%), and 4 severe cases (22.3%). The clinical factors associated with more severe cases of transient central retinal artery occlusion were the duration of the transient central retinal artery occlusion ( p = 0.001), number of prior injections ( p = 0.01), and a positive carotid Doppler test ( p = 0.01). Twelve cases (66.6%) had positive carotid artery obstruction (atheroma plaque size ≥70%) while 6 cases (33.3%) had negative carotid artery obstruction (atheroma plaque size <70%). The age group >60 years old ( p = 0.06), cup/disc ratio >0.6 ( p = 0.06), and pseudophakic lens status were also factors with association with transient central retinal artery occlusion, although did not meet criteria for statistical significance. The only patient who experienced a recurrent episode of transient central retinal artery occlusion had diabetic macular edema, positive carotid Doppler test, and cup/optic disc ratio >0.6. Conclusion Transient central retinal artery occlusion is a rare adverse event that can appear in patients with retinal vascular disease receiving anti-vascular endothelial growth factor therapy. The atheroma plaque size and the number of prior injections can be associated with the severity of the event.

Bilateral Central Retinal Artery Occlusion (CRAO) after Opium Consumption

2014 ◽  
Vol 3 (9) ◽  
Author(s):  
L. Rezaei ◽  
H. Ghanbari ◽  
M. Taghaodi ◽  
M. Malekahmadi ◽  
M. Adinevand ◽  
...  
Keyword(s):  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Retinal Artery

Central Retinal Artery Occlusion Following Prone Transcranial Surgery for Craniosynostosis and Discussion of Risk Factors

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Grayson Roumeliotis ◽  
Stewart Campbell ◽  
Sumit Das ◽  
Goran Darius Hildebrand ◽  
Peter Charbel Issa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Retinal Artery ◽  
Transcranial Surgery

scholarly journals The use of multimodal imaging in the evaluation of a patient with central retinal artery occlusion in the setting of asteroid hyalosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Timothy M. Janetos ◽  
Olga German ◽  
Rukhsana Mirza
Keyword(s):  
Multimodal Imaging ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Timely Diagnosis ◽  
Cardiovascular Morbidity And Mortality ◽  
Asteroid Hyalosis ◽  
Retinal Artery

Abstract Background A central retinal artery occlusion (CRAO) is an ophthalmic emergency due to its strong association with cerebrovascular and cardiovascular morbidity and mortality. A timely diagnosis is necessary but difficult in the setting of dense asteroid hyalosis, as typical fundoscopic findings can be obscured. We present a case where multimodal imaging in an eye with an obscured fundus could lead to timely diagnosis and management of CRAO in a patient with acute vision loss. Case presentation A 94-year-old Caucasian woman with a history of exudative macular degeneration presented to the retina clinic with acute vision loss in one eye over the course of an afternoon. The patient had dense asteroid hyalosis, and a direct retinal exam was not possible. Multimodal imaging suggested a CRAO diagnosis. The patient received digital ocular massage directly prior to undergoing fluorescein angiography (FANG), which confirmed the diagnosis. The patient was transported from clinic to the emergency room for an emergency stroke workup, which revealed a spontaneous echo in the left atrial appendage, and the patient was started on antiplatelet therapy. When she presented for follow-up within a week, the patient noted that her vision had improved at the time of digital ocular massage and continued to improve thereafter. Her FANG showed marked reperfusion of the retina, and she subsequently has completely regained her baseline visual acuity. Conclusions Multimodal imaging is useful in evaluating visual loss in patients with acute vision loss. In addition, ocular massage is a simple, low-risk intervention that may have benefit in the treatment of acute CRAO. Patients who present to ophthalmologists with an acute CRAO need an emergency referral for evaluation of cerebrovascular and cardiovascular comorbidities.

Central Retinal Artery Occlusion Associated with Severe Ovarian Hyperstimulation Syndrome

2001 ◽  
Vol 11 (3) ◽  
pp. 313-315 ◽  
Author(s):  
I.M. Turkistani ◽  
S.A. Ghourab ◽  
O.H. Al-Sheikh ◽  
A.M. Abu El-Asrar
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Vascular System ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Electrolyte Imbalance ◽  
Ovarian Hyperstimulation ◽  
Fluid Redistribution ◽  
Retinal Artery

Purpose Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication of ovulation induction. It is a potentially lethal condition, with severe complications which include ovarian enlargement, and massive fluid redistribution from the vascular system into free spaces resulting in ascites, pleural effusion, electrolyte imbalance, hemoconcentration, hypovolemia, oliguria, and adult respiratory distress syndrome. Thromboembolism is a rare but extremely serious complication. Case Report We report a case of severe OHSS, presenting with central retinal artery occlusion (CRAO). Discussion This combination has not been reported previously.

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