ABSTRACT
Coronavirus disease 2019 (COVID-19) vaccinations have been associated with a higher risk of thromboembolic events. There have been no reports of central retinal artery occlusion (CRAO) after vaccination with the indigenously developed Covaxin, and worldwide, there has been only one such isolated case after administration of the AstraZeneca vaccine. We report a case of a 44-year-old healthy man who presented with sudden painless vision loss in his left eye 10 days after receiving Covaxin. His best-corrected visual acuity was minimal perception of light, with a relative afferent pupillary defect. Fundus examination revealed arterial attenuation and macular cherry red spot, suggesting an acute CRAO. Optical coherence tomography showed macular swelling and disorganization of the inner layers due to ischemic sequelae. Blood work was normal and cardiovascular examination was unremarkable. The patient was kept on follow-up. To our knowledge, this is the first case of an isolated CRAO after Covaxin administration, but further studies are needed to evaluate this potential association.
ABSTRACT
In late 2019, we saw the emergence of a new coronavirus, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS?CoV?2), which rapidly evolved into a global pandemic. We report two cases of ocular vascular occlusion related to coronavirus disease 2019 (COVID?19) disease. The first case is of choroidal artery occlusion, while the second case is of combined central retinal artery and vein occlusion (CRAO and CRVO). We performed a thorough literature search and to the best of our knowledge, neither any of the above said has been reported in COVID?19–positive patients.
ABSTRACT
A 41?year?old man presented to the emergency department complaining of decrease of vision in his left eye. Initial examination was consistent with retrobulbar optic neuritis, and an intravenous drip of methylprednisolone was started. On the third day, the fundus examination revealed the appearance of multiple Purtscher?like cotton?wool spots in the posterior pole and nasally to the optic disc, slight retinal whitening around the fovea, and cherry?red spot. The patient reported flu?like symptoms, and he tested positive at PCR (polymerase chain reaction) test for 2019?nCoV (2019 novel coronavirus) infection. Assuming possible 2019?nCoV?related vascular damage, we prescribed low?molecular?weight heparin. The lesions were regressing at follow?up, and we registered a complete visual recovery
ABSTRACT
AIM: To observe the macular retina vascular density of patients with acute central retinal artery occlusion(CRAO)by optical coherence tomography angiography(OCTA)and to analyze the relationship with retinal circulation time of these patients on fundus fluorescein angiography(FFA).METHODS: Retrospective case analysis. A total of 43 patients(43 eyes)from January 2019 to March 2021 admitted to Shaanxi Eye Hospital with clinical diagnosis of acute CRAO(course of disease ≤7d)were included. All patients underwent FFA, OCTA, best corrected visual acuity(BCVA)examination and thrombolytic therapy. The patients with enhanced or unchanged retinal blood flow signal in the affected eye showed on OCTA before treatment compared with the contralateral healthy eye were assigned to group A, and the patients with retinal blood flow signal of the affected eye was lower than that in the contralateral healthy eye by OCTA were assigned to group B. Image J software was used for OCTA image processing to evaluate the macular retina vascular density before treatment, and FFA examination was performed to record the affected retinal circulation time before treatment.RESULTS: The retinal vascular density of patients in the affected eye and the contralateral healthy eye in group A was higher than that in group B(25.08%±4.40% vs 12.24%±3.41%, 25.72%±2.70% vs 17.89%±4.55%, all P<0.001), the filling time(FT)of retinal artery trunk to terminal in group B [96(20.50, 193.50)s] was longer than that in group A [11(5.00, 19.50)s](P<0.001). The course of disease, the retinal vascular density of contralateral healthy eye and FT were related factors of retinal vascular density of the affected eye(all P<0.05), and the influence strength order was FT, course of disease and the retinal vascular density of contralateral healthy eye, in which the course of disease and FT was negatively correlated with the retinal vascular density.CONCLUSION: OCTA retinal vascular density was correlated with FFA retinal circulation time in CRAO patients.
ABSTRACT
A 59-year-old female farmer presented with left painful swollen eye for 1 week after being stung by a rice black bug ( Scotinophara sp. ). It was associated with acute progressive blurring of vision. On examination of the left eye, there was a marked periorbital swelling with proptosis and complete ptosis. The extraocular movements were restricted in all the directions. The cornea was hazy with large epithelial defect. Fundoscopy showed combined features of both central retinal vein and artery occlusions with swollen optic disc and ischaemia of the macular area. CT scan and MRI of orbit and brain showed evidence of orbital soft tissue inflammation. Patient was diagnosed with left orbital cellulitis, keratouveitis and central retinal vein and artery occlusions. The periorbital swelling and proptosis were improved after treatment with systemic and topical antibiotics. However, the vision remained no perception of light(NPL)and limitation of ocular movements persisted. The potential ophthalmic insults by Scotinophara sp. Can be severe and permanent. Awareness of the debilitating insults by Scotinophara sp. To human eye should be instilled timely especially in its prone areas.
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·AIM:To describe an unusual combination of retinal manifestations in an AIDS patient with progressive outer retinal necrosis (PORN),complicated by combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO).·METHODS:A case report.·RESULTS:The patient presented with PORN with primary optic nerve involvement complicated by combined central retinal artery occlusion(CRAO) and central retinal vein occlusion(CRVO) as a primary manifestation of Varicella Zoster Virus (VZV).Aggressive treatment with intravitreal and specific systemic anti-VZV therapy,in addition to systemic highly active antiretroviral therapy (HAART) achieved retinal quiescence with sparing of the fellow eye.Visual outcome of the affected eye was poor.·CONCLUSION:We present the first report of PORN associated with the unusual combined complications of CRAO and CRVO. Aggressive local treatment was combined with systemic therapy,which achieved local control and empirical prophylaxis for the fellow eye.
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PURPOSE: To investigate magnetic resonance angiographic findings of central retinal artery occlusion (CRAO) patients. METHODS: In 14 CRAO patients who had admitted in our hospital from 1996 to 2001, retrospective studies were done. All patients were checked head and neck magnetic resonance angiography (MRA), echocardiography, and systemic examination including blood test. RESULTS: There were a stenosis (6 cases) or occlusion (3 cases) of carotid artery in 9 of 14 persons. In CRAO patients, there were increasement of serum LDL-cholesterol and decreasement of cardiac ejection fraction as compared with normal group. In the group with carotid arterial lesion, serum LDL-cholesterol was increased and cardiac ejection fraction was decreased as compared with the group without carotid arterial lesion, but there was no statistical significance. CONCLUSIONS: Large amounts of CRAO patients have carotid arterial stenosis, so MRA and brain MRI are needed in CRAO patient to evaluate carotid arterial lesion as well as intracranial lesion. If the lesion is identified, it is prefered to take appropriate treatment. More study is needed about importances of increased LDL-cholesterol and decreased ejection fraction in CRAO patient.
Subject(s)
Humans , Brain , Carotid Arteries , Constriction, Pathologic , Echocardiography , Head , Hematologic Tests , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Neck , Retinal Artery Occlusion , Retinal Artery , Retrospective StudiesABSTRACT
Central retinal artery occlusion occurs rarely as a complication of spine surgery in prone position, but is quite tragic. The suggested cause are hypotensive anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion(CRAO) after surgery of C4-5 fracture-dislocation using a horseshoe headrest and report this case.
Subject(s)
Anesthesia , Prone Position , Retinal Artery Occlusion , Retinal Artery , SpineABSTRACT
The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.
Subject(s)
Female , Humans , Middle Aged , Fluorescein , Optic Nerve , Orbit , Retinal Artery Occlusion , Retinal ArteryABSTRACT
The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.