Limits...
Hemi-central retinal artery occlusion in young adults.

Rishi P, Rishi E, Sharma T, Mahajan S - Indian J Ophthalmol (2010 Sep-Oct)

Bottom Line: The third patient had Leiden mutation while the fourth patient had Eisenmenger's syndrome.Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases.The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

View Article: PubMed Central - PubMed

Affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Tamil Nadu, India.

ABSTRACT
Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger's syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

Show MeSH

Related in: MedlinePlus

Case 4. Left eye ERG reveals a normal ‘a’ wave response and a reduced ‘b’ wave. This corresponds to inner retinal ischemia consequent to retinal vascular occlusion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2992922&req=5

Figure 0020: Case 4. Left eye ERG reveals a normal ‘a’ wave response and a reduced ‘b’ wave. This corresponds to inner retinal ischemia consequent to retinal vascular occlusion

Mentions: A 22-year-old young man, a known case of congenital heart disease, reported with decreased vision in left eye since two days. Vision was 20/20 in both eyes. Anterior segment examination was essentially normal. Right fundus was normal. Left fundus revealed retinal edema involving superior half, sparing fovea with no embolus [Fig. 18]. Findings of FFA [Fig. 19], ERG [Fig. 20], visual field examination [Fig. 21] and color Doppler study of the right eye [Fig. 22] are summarized in Table 1. A summary of systemic investigations and treatment is included in Table 2. Diagnosed to have Eisenmenger syndrome, the probable cause of vascular occlusion was paradoxical embolism through ventricular septal defect. At six weeks review, retinal edema had reduced with no evidence of anterior segment neovascularisation.


Hemi-central retinal artery occlusion in young adults.

Rishi P, Rishi E, Sharma T, Mahajan S - Indian J Ophthalmol (2010 Sep-Oct)

Case 4. Left eye ERG reveals a normal ‘a’ wave response and a reduced ‘b’ wave. This corresponds to inner retinal ischemia consequent to retinal vascular occlusion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2992922&req=5

Figure 0020: Case 4. Left eye ERG reveals a normal ‘a’ wave response and a reduced ‘b’ wave. This corresponds to inner retinal ischemia consequent to retinal vascular occlusion
Mentions: A 22-year-old young man, a known case of congenital heart disease, reported with decreased vision in left eye since two days. Vision was 20/20 in both eyes. Anterior segment examination was essentially normal. Right fundus was normal. Left fundus revealed retinal edema involving superior half, sparing fovea with no embolus [Fig. 18]. Findings of FFA [Fig. 19], ERG [Fig. 20], visual field examination [Fig. 21] and color Doppler study of the right eye [Fig. 22] are summarized in Table 1. A summary of systemic investigations and treatment is included in Table 2. Diagnosed to have Eisenmenger syndrome, the probable cause of vascular occlusion was paradoxical embolism through ventricular septal defect. At six weeks review, retinal edema had reduced with no evidence of anterior segment neovascularisation.

Bottom Line: The third patient had Leiden mutation while the fourth patient had Eisenmenger's syndrome.Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases.The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

View Article: PubMed Central - PubMed

Affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Tamil Nadu, India.

ABSTRACT
Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger's syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

Show MeSH
Related in: MedlinePlus