scholarly journals Purtscher-like Retinopathy Associated with High Altitude Travel

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000022
Author(s):  
Luke Y. Chang ◽  
Cindy W. Mi ◽  
Lily Im ◽  
Marena Patronas
Keyword(s):  
High Altitude ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Vessel ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Cotton Wool Spots ◽  
Retinal Artery ◽  
Funduscopic Examination ◽  
Plexiform Layers

Purpose To report a case of Purtscher-like retinopathy associated with travel at high altitude. Methods Case report. Results A 67-year-old man presented 2 weeks after acute vision loss in his left eye that occurred while he was hiking in the mountains of South America. Funduscopic examination revealed multiple cotton-wool spots and discrete areas of retinal whitening. Fluorescein angiography demonstrated areas of choroidal fluorescence blocked by retinal whitening, delayed arteriovenous transit time, and late capillary leakage. Spectral-domain optical coherence tomography showed hyperreflectivity in the inner plexiform, inner nuclear, and outer plexiform layers localized to the areas of retinal whitening. These findings were believed to be most consistent with Purtscher flecken, and the patient was diagnosed with Purtscher-like retinopathy. Conclusions Purtscher-like retinopathy may be linked to travel at high altitude through retinal vessel dilation and constriction leading to retinal vasospasm and precapillary arteriole occlusion. This proposed mechanism of pathogenesis suggests that Purtscher-like retinopathy may represent a partial central retinal artery occlusion.

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.

scholarly journals Concurrent Bilateral Central Retinal Artery Occlusion Secondary to Sickle Cell Crisis

2021 ◽  
Vol 9 ◽  
pp. 232470962110283
Author(s):  
Gowri Renganathan ◽  
Piruthiviraj Natarajan ◽  
Lela Ruck ◽  
Roberto Prieto ◽  
Bharat Ved Prakash ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Cell Disease ◽  
Sickle Cell Crisis ◽  
History Of ◽  
Retinal Artery

Vascular occlusive crisis with a concurrent vision loss on both eyes is one of the most devastating disability for sickle cell disease patients. Reportedly occlusive crisis in the eyes is usually temporary whereas if not appropriately managed can result in permanent vision loss. A carefully managed sickle cell crisis could prevent multiple disabilities including blindness and stroke. We report a case of a 24-year-old female with a history of sickle cell disease who had acute bilateral vision loss during a sickle crisis and recovered significantly with a timely emergent erythrocytapheresis.

scholarly journals Case Report: Central Retinal Artery Occlusion in a COVID-19 Patient

2020 ◽  
Vol 11 ◽  
Author(s):  
Andrea Montesel ◽  
Claudio Bucolo ◽  
Victoria Mouvet ◽  
Emmanuelle Moret ◽  
Chiara M. Eandi
Keyword(s):  
Vision Loss ◽  
Previous History ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
History Of ◽  
Severe Vision Loss ◽  
Retinal Artery ◽  
Vascular Occlusions

We report a case of central retinal artery occlusion (CRAO) in a patient with a previous history of severe COVID-19 disease. This disease has been associated with inflammatory-induced homeostasis changes leading to endothelial dysfunction and a procoagulant state with multi-organ involvement, but the burden of thromboembolic complications in COVID-19 patients is currently unknown. The pathogenesis of retinal artery occlusions is a multifactorial process where inflammation and hypercoagulation state are established risk factors. Even if our experience may represent a coincidental relationship, it is likely that COVID-19 patients could be at risk of developing retinal vascular occlusions. A focused ophthalmological surveillance is advisable to prevent and manage this possible cause of severe vision loss that has an important impact in health care system.

Bilateral Central Retinal Artery Occlusion in Infective Endocarditis

2020 ◽  
pp. 247412642096090
Author(s):  
Mohamed Mohamed ◽  
Tahira Scholle
Keyword(s):  
Infective Endocarditis ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Motion Vision ◽  
Hand Motion ◽  
Cherry Red Spot ◽  
Retinal Artery

Purpose: This report describes a patient with bilateral, sequential central retinal artery occlusions (CRAOs) due to infective endocarditis (IE). Methods: A case report is presented. Results: A 35-year-old man with IE who recently completed a course of intravenous antibiotic therapy presented with sudden right-eye vision loss. Examination revealed hand motion vision, a cherry-red spot in the macula in the right eye, and an embolus in the inferotemporal arcade of the left eye. The diagnosis of right-eye CRAO secondary to IE was made, with the presumed source being his dental caries. The patient was admitted with plans for aortic valve replacement and dental extraction. During his hospitalization, the patient suffered from a CRAO in his left eye, resulting in bilateral loss of vision. Conclusions: IE can have severe embolic complications; prompt diagnosis and treatment medically and surgically are necessary to reduce further morbidity and mortality.

Central retinal artery occlusion from Streptococcus gallolyticus endocarditis

2020 ◽  
Vol 13 (9) ◽  
pp. e235763
Author(s):  
Rita Serras-Pereira ◽  
Diogo Hipolito-Fernandes ◽  
Luísa Azevedo ◽  
Luísa Vieira
Keyword(s):  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Transoesophageal Echocardiography ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Streptococcus Gallolyticus ◽  
Cardiovascular Comorbidities ◽  
Cherry Red Spot ◽  
Retinal Artery

Central retinal artery occlusion (CRAO) is a rare but blinding disorder. We present a case of a 81-year-old woman with multiple cardiovascular comorbidities admitted to the emergency department due to sudden, painless vision loss on left eye (oculus sinister (OS)) on awakening. The patient also reported long standing fatigue associated with effort that started 4 months before admission. She presented best corrected visual acuity of counting fingers OS. Funduscopy OS revealed macular oedema with cherry red spot pattern. Blood cultures came positive for Streptococcus gallolyticus in the context of a bacteremia and native mitral valve vegetation identified on transoesophageal echocardiography. CRAO of embolic origin was admitted in the context of an infective endocarditis. CRAO can be the first manifestation of a potentially fatal systemic condition and thus multidisciplinary approach is warranted with close collaboration between ophthalmologists and internists in order to provide proper management and the best possible treatment.

Intra-Arterial Thrombolytic Therapy Is Not a Therapeutic Option for Filler-Related Central Retinal Artery Occlusion

2018 ◽  
Vol 34 (03) ◽  
pp. 325-329 ◽  
Author(s):  
Yi-Chun Chen ◽  
Hsiu-Mei Wu ◽  
Shih-Jen Chen ◽  
Han-Jui Lee ◽  
Jiing-Feng Lirng ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
Vision Loss ◽  
Therapeutic Option ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Dermal Filler ◽  
Facial Filler ◽  
Retinal Artery

AbstractCosmetic facial filler-related central retinal artery occlusion (CRAO) is a devastating complication of facial hyaluronic acid (HA) injection and can be managed by intra-arterial thrombolytic therapy (IATT). The authors report on a 20-year-old woman who developed unilateral CRAO due to facial HA injection and who, despite prompt IATT, lost vision. A review of the related literature found 14 other female patients who developed cosmetic facial filler-related CRAO and accepted IATT management. In no case was vision loss clinically improved. IATT is not an effective preventive treatment of dermal filler-associated CRAO. The authors suggest careful preprocedural patient selection to prevent this complication.

scholarly journals Paracentral acute middle maculopathy in the setting of central retinal artery occlusion following COVID-19 diagnosis

2021 ◽  
pp. 112067212199534
Author(s):  
Neslihan Turedi ◽  
Betul Onal Gunay
Keyword(s):  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Significant Past Medical History ◽  
Normal Limits ◽  
First Case ◽  
Retinal Artery ◽  
Work Up

Background: Since its emergence in Wuhan, China, COVID-19 has disseminated across many other countries worldwide. In this report, we firstly presented a patient with mild COVID-19 disease who developed paracentral acute middle maculopathy (PAMM) due to CRAO. Case presentation: A 54-year-old male patient who reported a contact with a COVID-19 patient applied to the hospital and tested positive for SARS-CoV-2 by polimerase chain reaction testing. He had no significant past medical history. Chest computed tomography was not notable. He had a mild COVID-19 course during hospitalization. Two weeks following COVID-19 diagnosis, he reported profund vision loss (counting fingers) in his right eye where central retinal artery occlusion (CRAO) was detected on fundoscopic examination. Coagulation profile was within normal limits. Hypercoagulable work up was also not notable. Treatment was given for CRAO. Visual acuity was counting fingers at 30 cm. Five days following treatment. Optical coherence tomography analysis showed increased diffuse reflectance and thickening at the level of inner nuclear layer consistent with PAMM. Fluorescein angiography illustrated no perfusion defect. Conclusion: This is the first case that reports PAMM in the setting of CRAO following COVID-19 diagnosis. Viral induced microangiopathy may involve in the development of CRAO in our patient without a hypercoagulable state and additional risk factors. Physicians should be vigilant to seek for retinal evaluation in patients with significant visual loss even after a mild COVID-19 history.

scholarly journals Central Retinal Artery Occlusion as a Complication in Invasive Aesthetic Cosmetology: a Clinical Case

2021 ◽  
Vol 18 (3) ◽  
pp. 584-590
Author(s):  
V. N. Trubilin ◽  
E. G. Poluninа ◽  
V. V. Kurenkov ◽  
K. V. Chinenova ◽  
A. S. Yatsun ◽  
...  
Keyword(s):  
Clinical Case ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Ophthalmological Examination ◽  
Arterial Blood ◽  
Retinal Artery ◽  
The Right

Central retinal artery occlusion (CRAO) is a relatively rare form of acute retinal arterial ischemia that results in unilateral vision loss. The incidence of transient vision loss is estimated at approximately 14 cases per 100,000 people per year, while the incidence of CRAO is approximately 1–2 cases per 100,000 people. In the foreign literature, there are more and more publications about the development of iatrogenic vision loss after dermal cosmetic injections. We would like to present a clinical case that should be interesting for both practicing ophthalmologists and specialists of related specialties, especially for cosmetologists. Patient M., 42 years old, came to us with complaints of a sharp loss of vision to light perception in the right eye. From the anamnesis, it is known that two hours earlier, the patient was injected into the temporal region (plasma, anesthetic, epinephrine) in the cosmetology office. Lightning-fast deterioration of vision occurred at the time of the drug administration. The patient arrived at the clinic 2 hours after the onset of complaints. We conducted an ophthalmological examination of the patient, the diagnosis was made: occlusion of the central artery of the retina of the right eye, and immediately performed standard emergency therapy. After a course of conservative treatment in an ophthalmological hospital, a persistent decrease in visual functions and a violation of arterial blood circulation in the central retinal artery basin remained. The progressive increase in the number of minimally invasive cosmetic procedures in recent years, in particular, injections of dermal fillers, is associated with rare, but often fatal complications. This clinical situation should attract the attention of practicing ophthalmologists and cosmetologists to these types of complications, and improve the quality and speed of emergency medical care.

scholarly journals Odontogenic orbital cellulitis in a young man with complete vision loss – a case report

2020 ◽  
Vol 66 (4) ◽  
pp. 41-45
Author(s):  
Maciej Sikora ◽  
Krzysztof Wróbel ◽  
Agata Stąpor ◽  
Marcin Sielski ◽  
Dariusz Chlubek
Keyword(s):  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Lactobacillus Rhamnosus ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Pharmacological Therapy ◽  
Orbital Cellulitis ◽  
Ischemic Optic Neuropathy ◽  
Resonance Test ◽  
Retinal Artery

Abstract Odontogenic inflammation in humans can spread to adjacent anatomical structures, causing pathological changes that are dangerous to health and, in some cases, life. In this paper, we present an unusual case of odontogenic orbital cellulitis caused by both Lactobacillus rhamnosus and Enterococcus avium, which resulted in blindness of the eye in a 25-year-old man. Orbital cellulitis is more common in children due to the relative immaturity of their immune systems whereas it is rare in adults – in most cases, it occurs as a complication of paranasal sinusitis. An accurate diagnosis requires not only a thorough clinical examination but also appropriate imaging tests (such as a computed tomography or nuclear magnetic resonance test). Successful treatment largely depends on the earliest possible implementation of pharmacological therapy. In cases where it is justified, surgical procedures to decompress and drain the abscess should also be considered. However, in the case described in this publication, the patient did not regain vision in the affected eye despite the implementation of both intensive pharmacological treatment and surgical treatment, probably due to ischemic optic neuropathy and central retinal artery occlusion caused by severe infraorbital oedema.

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