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 EMERGENCY TREATMENT FOR CENTRAL RETINAL ARTERY OCCLUSION ( CRAO )

2021 ◽  
Vol 1 (2) ◽  
pp. 7-8
Author(s):  
Nida Farida
Keyword(s):  
Visual Acuity ◽  
Emergency Treatment ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Blurred Vision ◽  
Retinal Artery ◽  
Ocular Chamber ◽  
The Right

Central retinal artery occlusion (CRAO) is a blinding event but not considered as a common emergency problem. Since awareness of the case is low, patients usually come to the ophthalmologist later than the golden period and havingthe worst prognosis. We report the case of patient with a central retinal artery occlusion that had visual improvement after emergency treatment.A 47-year-old woman with no comorbidities presented with symptoms of a sudden blurred vision, no pain or redness in the right eye (RE). Best-corrected visual acuity in the RE was 1/60. A relative afferent pupillary defect was observed in the RE. Ocular fundus examination of RE was suggestive of CRAO. Emergency treatment were performed, including rebreathing of expired CO2, ocular massage and ocular chamber paracentesis. One week later, the visual acuity was improved.This case highlights that fast and accurate response in acute management of CRAO should be conducted, especially within the golden hours which is less than 6 hours after the accident, to prevent permanent visual loss of thepatient.

Hyperbaric oxygen treatment results in a group of Turkish central retinal artery occlusion patients with a combined presence of thrombophilic mutations

2020 ◽  
pp. 65-73
Author(s):  
Muhammer Özgür Çevik ◽  
◽  
Bekir Selim Bağli ◽  
Sadık Görkem Çevik ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Factor V ◽  
Factor V G1691a ◽  
Retinal Artery ◽  
Pai 1 ◽  
Hbo2 Therapy ◽  
Thrombophilic Mutations

Background: Central retinal artery occlusion (CRAO) is a rare ocular-ischemic syndrome causing irreversible blindness. Its pathophysiology has not been clarified, and no targeted therapies are available yet. Hyperbaric oxygen (HBO2) therapy is an approved therapy for CRAO and has been shown to improve the visual acuity of CRAO patients safely. However, further clinical data are required to classify HBO2 therapy as a type-I general agreement for CRAO. Materials and Methods: Eleven patients with non-arteritic CRAO were enrolled. Patient demographics, medical history, detailed eye examinations, HBO2 therapy results, pre-/post- HBO2 therapy visual acuity measurements and genotypes for common thrombophilic mutations (Factor V G1691A Leiden, Factor II G20210A, MTHFR A1298C, MTHFR C677T, and PAI-1-675 4G/5G) were obtained. Results: Six patients (54%) responded to HBO2 therapy compared to five non-responders (46%). Patients admitted before 12 hours responded well to HBO2 therapy. No systemic diseases nor advanced age were statistically correlated to CRAO. A combination of mutations rather than single mutations for each patient could be seen as responsible for CRAO. No Factor V G1691A Leiden mutations and only one FII G20210A mutation were observed. Eight patients (72%) had MTHFR 677T allele, five patients (45%) had MTHFR 1298C allele, and 10 patients (91%) had the PAI-1-675 4G allele. Conclusion: Not a single mutation but a combination of mutations and other unknown factors probably lead to CRAO, and if intervention is timely, HBO2 therapy offers improvement in visual acuity safely.

The effect of adjunctive hyperbaric oxygen therapy in patients with central retinal artery occlusion

2020 ◽  
pp. 57-64
Author(s):  
Yoon-Seop Kim ◽  
◽  
Myung-Sik Nam ◽  
Eung Joo Park ◽  
Yoonsuk Lee ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Medical Society ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Cilioretinal Artery ◽  
Retinal Artery

Purpose: Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor prognosis, despite diligent conventional treatment. According to the clinical recommendations of the Undersea and Hyperbaric Medical Society hyperbaric oxygen (HBO2) is a potentially beneficial treatment; however, the benefit of adjunctive HBO2 in patients with CRAO in Korea remains unclear. The present study aimed to evaluate the effect of adjunctive HBO2 in patients with CRAO. Methods: This registry-based observational study included adult patients who presented to the emergency department or ophthalmology outpatient department within 24 hours of the onset of CRAO symptoms. Data of patients from October 2016 to February 2019 were analyzed. The patients were categorized into two groups according to the use of adjunctive HBO2: no HBO2 and HBO2. Result: During the study period, 34 consecutive patients were enrolled, of which 19 were included in the study. In the total cohort, 10 patients (52.6%) were treated with adjunctive HBO2. There were no statistically significant differences in terms of age, sex, comorbidities, duration from symptoms onset to hospital visit, presence of the cilioretinal artery, and use of anterior chamber paracentesis between the two groups. The HBO2 group showed significantly higher change in best-corrected visual acuity than the no-HBO2 group (p=0.043). Conclusion: Patients with CRAO in the HBO2 group showed significantly greater visual improvement than those in the no HBO2 group. Clinicians should consider adjunctive HBO2 in the treatment approach in patients with CRAO who visit the hospital within 24 hours of symptoms onset.

scholarly journals A Case of Incomplete Central Retinal Artery Occlusion Associated with Short Posterior Ciliary Artery Occlusion

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Shinji Makino ◽  
Mikiko Takezawa ◽  
Yukihiro Sato
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Ophthalmic Artery ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Posterior Ciliary Artery ◽  
Retinal Artery ◽  
Ciliary Artery

To our knowledge, incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion is extremely rare. Herein, we describe a case of a 62-year-old man who was referred to our hospital with of transient blindness in his right eye. At initial examination, the patient’s best-corrected visual acuity was 18/20 in the right eye. Fundus examination showed multiple soft exudates around the optic disc and mild macular retinal edema in his right eye; however, a cherry red spot on the macula was not detected. Fluorescein angiography revealed delayed dye inflow into the nasal choroidal hemisphere that is supplied by the short posterior ciliary artery. The following day, the patient’s visual acuity improved to 20/20. Soft exudates around the optic disc increased during observation and gradually disappeared. His hemodynamic parameters revealed subclavian steal syndrome as examined by cervical ultrasonography and digital subtraction angiography. We speculate that his transient blindness was due to ophthalmic artery spasms. In this particular case, spasms of the ophthalmic artery and occlusion of the short posterior ciliary artery occurred simultaneously. As the short posterior ciliary artery branches from the ophthalmic artery, the anatomical location of the lesion might be near the branching of both arteries.

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

2020 ◽  
Author(s):  
Jun Xiong ◽  
Guiling Liang ◽  
Liang Hu ◽  
Wei Chen ◽  
Jie Deng ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prone Position ◽  
Spine Surgery ◽  
Visual Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Efficacious Treatment ◽  
Retinal Artery ◽  
Visual Acuity Loss

Abstract Background: Visual loss after spine surgery in prone position is disastrous postoperative complication because it is almost irreversible. Meamwhile, there is no optimal treatments and recommended peofessional guidelines. Case presentation: A 43 years old male patient complained visual loss after spine surgery in prone position. Immediate ophthalmic consultation undoubtedly considered central retinal artery occlusion, therefore combined therapies were administered including neurotrophy, anticoagulation, vasodilation and adequate fluid infusion, followed by hyperbaric oxygen treatment. After active treatment, his visual acuity recovered from postoperative 5 hours gradually. Conclusion: Because there is shortage of efficacious treatment against visual loss after spine surgery in prone position, the best method avoiding this complication is to pay great attention and prevent it.

scholarly journals Transient visual acuity loss after spine surgery in the prone position: a case report and literature review

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095227
Author(s):  
Jun Xiong ◽  
Guiling Liang ◽  
Liang Hu ◽  
Wei Chen ◽  
Jie Deng ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Prone Position ◽  
Spine Surgery ◽  
Visual Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Retinal Artery ◽  
Visual Acuity Loss ◽  
Professional Guidelines

Visual loss after spine surgery in the prone position is a disastrous postoperative complication because it is almost irreversible. Additionally, the optimal treatments and recommended professional guidelines for visual loss after spine surgery are deficient. A 43-year-old man developed visual loss after spine surgery in the prone position. Immediate ophthalmic consultation confirmed central retinal artery occlusion. Therefore, combined therapies were administered, including neurotrophy, anticoagulation, vasodilation, and adequate fluid infusion, followed by hyperbaric oxygen treatment. After active treatment, his visual acuity gradually recovered from 5 hours postoperatively and continued to improve thereafter. We reviewed the literature on postoperative visual loss with a focus on spine surgery in the prone position. Because the etiology of this complication is complex and has few effective treatments, the best method for its avoidance is to pay close attention to preventing it during surgery.

Sign in / Sign up

Export Citation Format

Share Document