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Undiagnosed patent foramen ovale presenting as retinal artery occlusion-an emerging association.

Sheth HG, Laverde-Konig T, Raina J - J Ophthalmol (2009)

Bottom Line: Results.Conclusions.These events may be ophthalmic with visual sequelae and so ophthalmologists, physicians, and other healthcare personnel should be aware of this important and emerging association.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK.

ABSTRACT
Purpose. To report patent foramen ovale (PFO) as the cause of retinal artery occlusion in a young and previously fit male and discuss the appropriate medical and surgical management options. Methods. Interventional case report with serial fundus photographs of an 18-year-old male presenting to the eye casualty with sudden onset left visual loss. Results. Visual acuities were 6/24 left and 6/4 right with a left afferent pupillary defect. Slitlamp examination confirmed a left hemiretinal artery occlusion and subsequent cardiology review with transoesophageal echocardiography revealed patent foramen ovale which was closed surgically. Conclusions. PFO is not uncommon and is often covert but predisposes individuals to embolic events. These events may be ophthalmic with visual sequelae and so ophthalmologists, physicians, and other healthcare personnel should be aware of this important and emerging association.

No MeSH data available.


Related in: MedlinePlus

Colour photograph of left fundus at presentation, showing acute left hemiretinal artery occlusion and associated retinal oedema.
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fig1: Colour photograph of left fundus at presentation, showing acute left hemiretinal artery occlusion and associated retinal oedema.

Mentions: An 18-year-old male presented to the eye casualty with a history of left visual loss, which had occurred suddenly an hour previously. He had no past ophthalmic history, gave a past medical history of classical migraine (with visual aura and headache), and had endured a long distance bus journey the preceding day. There was no history of cigarette smoking or illicit drug use. Visual acuities were 6/24 left unaided not improving with pinhole and 6/4 unaided right. A left afferent pupillary defect (RAPD) was present, and loss of left superior visual field to confrontation with red pin was demonstrated. Intraocular pressures were normal and gonioscopy confirmed open iridocorneal angles. Dilated fundal examination revealed a left inferior hemi-retinal artery occlusion (Figure 1). Systemic neurological examination was normal, and blood pressure was 115/68. Immediate treatment included aspirin orally, acetazolomide intravenously, ocular massage, and rebreathing into a paper bag.


Undiagnosed patent foramen ovale presenting as retinal artery occlusion-an emerging association.

Sheth HG, Laverde-Konig T, Raina J - J Ophthalmol (2009)

Colour photograph of left fundus at presentation, showing acute left hemiretinal artery occlusion and associated retinal oedema.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2836926&req=5

fig1: Colour photograph of left fundus at presentation, showing acute left hemiretinal artery occlusion and associated retinal oedema.
Mentions: An 18-year-old male presented to the eye casualty with a history of left visual loss, which had occurred suddenly an hour previously. He had no past ophthalmic history, gave a past medical history of classical migraine (with visual aura and headache), and had endured a long distance bus journey the preceding day. There was no history of cigarette smoking or illicit drug use. Visual acuities were 6/24 left unaided not improving with pinhole and 6/4 unaided right. A left afferent pupillary defect (RAPD) was present, and loss of left superior visual field to confrontation with red pin was demonstrated. Intraocular pressures were normal and gonioscopy confirmed open iridocorneal angles. Dilated fundal examination revealed a left inferior hemi-retinal artery occlusion (Figure 1). Systemic neurological examination was normal, and blood pressure was 115/68. Immediate treatment included aspirin orally, acetazolomide intravenously, ocular massage, and rebreathing into a paper bag.

Bottom Line: Results.Conclusions.These events may be ophthalmic with visual sequelae and so ophthalmologists, physicians, and other healthcare personnel should be aware of this important and emerging association.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK.

ABSTRACT
Purpose. To report patent foramen ovale (PFO) as the cause of retinal artery occlusion in a young and previously fit male and discuss the appropriate medical and surgical management options. Methods. Interventional case report with serial fundus photographs of an 18-year-old male presenting to the eye casualty with sudden onset left visual loss. Results. Visual acuities were 6/24 left and 6/4 right with a left afferent pupillary defect. Slitlamp examination confirmed a left hemiretinal artery occlusion and subsequent cardiology review with transoesophageal echocardiography revealed patent foramen ovale which was closed surgically. Conclusions. PFO is not uncommon and is often covert but predisposes individuals to embolic events. These events may be ophthalmic with visual sequelae and so ophthalmologists, physicians, and other healthcare personnel should be aware of this important and emerging association.

No MeSH data available.


Related in: MedlinePlus