ABSTRACT
We describe an effective surgical approach for the management of cilioretinal artery occlusion. A 23?G pars plana vitrectomy assisted with two soft tip cannulas was performed. One cannula pressed the cilioretinal artery branch directed toward the macula, distal to the location of the embolus, whereas the other cannula was used to gently swipe over the cilioretinal artery proximal to the occlusion. Anatomical and functional outcomes were evaluated by fundus examination, fluorescein angiography, Goldmann visual field, and best?corrected visual acuity (BCVA). It was possible to mobilize the embolus by mechanical displacement with 23?G soft?tip cannulas and disintegrate it, preventing the passage toward the branch directed to the macula. Restoration of retinal circulation was confirmed by fluorescein angiogram. The patient recovered his previous documented BCVA and visual field. The described technique can be considered as a new possibility for achieving a solution to cilioretinal artery occlusion or any other retinal artery occlusion
ABSTRACT
A high incidence of venous thromboembolism has been reported in patients who have had renal transplantation especially within the early postoperative period. Herein, the management of a 31- year-old renal graft recipient with the diagnosis of combined left central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CRAO) is presented. Although detailed work-up for inherited as well as acquired thrombophilic disorders was performed in our case, none of the definite prothrombotic and predisposing risk factors for venous thromboembolism was identified. The case under review or the index case had a remarkable visual recovery within 3 weeks after the referral, since anterior chamber paracentesis was immediately scheduled after performing ocular massage in order to achieve acute resolution of venous stasis.
ABSTRACT
Cocaine is used to produce a euphoric effect by abusers, who may be unaware of the devastating systemic and ocular side effects of this drug. We describe the first known case of cilioretinal artery occlusion after intranasal cocaine abuse.
Subject(s)
Acetazolamide/administration & dosage , Administration, Oral , Ciliary Arteries , Cocaine/poisoning , Cocaine-Related Disorders/complications , Diagnosis, Differential , Female , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Humans , Infusions, Intravenous , Mannitol/administration & dosage , Massage/methods , Retinal Artery Occlusion/chemically induced , Retinal Artery Occlusion/diagnosis , Retinal Artery Occlusion/therapy , Visual Acuity , Visual Field Tests , Visual Fields , Young AdultABSTRACT
PURPOSE: To report a case of isolated cilioretinal artery occlusion associated with pseudoexfoliation syndrome. METHODS: A 66-year-old female presented with acute vision loss of the right eye. Three months prior, she had been diagnosed as having pseudoexfoliation glaucoma of both eyes, and the intraocular pressure of both eyes had been well-controlled with topical medication. RESULTS: The presenting visual acuity in her right eye was 20/100. Fundus examinations showed sectoral retinal whitening on superior macula. Fluorescein angiography revealed delayed filling of the cilioretinal artery, consistent with cilioretinal artery occlusion. No significant findings were identified by carotid doppler examination or echocardiography. After 8 weeks, retinal changes were completely resolved with improvement of her right vision to 20/25. CONCLUSIONS: Isolated cilioretinal artery occlusion may develop as an intraocular manifestation of pseudoexfoliation syndrome.
Subject(s)
Aged , Female , Humans , Arteries , Echocardiography , Exfoliation Syndrome , Fluorescein Angiography , Glaucoma , Intraocular Pressure , Ischemia , Retinaldehyde , Visual AcuityABSTRACT
PURPOSE: To report a case of cilioretinal artery occlusion following the intranasal injection of corticosteroids. METHODS: A 52-year-old man was referred to the ophthalmologic clinic due to a marked loss of vision in his right eye immediately after endoscopic sinus surgery. At that time, his vision was noted to be counting fingers in the right eye. His pupil was mid-dilated, fixed, and did not respond to light on examination. On ophthalmoscopy, macula edema with retinal ischemia, and a cherry-red spot were seen in the posterior pole of the retina. Ocular massage was carried out immediately after ophthalmologic examination. Three days later, visual acuity in the right eye improved to 0.15. Fluorescein angiography revealed filling defects of the cilioretinal artery and peripheral branches of the retinal arteries. In addition, areas of nonperfusion were observed. RESULTS: During the follow-up periods, macula edema resolved and visual acuity in the right eye improved to 1.2 after 3 months. Fluorescein angiogram was repeated and showed that the filling defects had disappeared. CONCLUSIONS: Retinal artery occlusion can occur after an intranasal injection of corticosteroids due to embolization of retinal circulation. This condition can be improved without complications by no other specific therapy.
Subject(s)
Humans , Middle Aged , Adrenal Cortex Hormones , Arteries , Edema , Fingers , Fluorescein , Fluorescein Angiography , Follow-Up Studies , Ischemia , Massage , Ophthalmoscopy , Pupil , Retina , Retinal Artery , Retinal Artery Occlusion , Retinaldehyde , Visual AcuityABSTRACT
Central retinal vein occlusion(CRVO)is characterized by rapid, painless decrease in visual acuity, edema of the optic disc and retina, marked dilatation and tortuosity of the retinal veins, and extensive retinal hemorrhages in all quardrants.Many ocular and systemic conditions associated with CRVO include diabetes, hypertension, collagen vascular disorder, hyperviscosity syndrome and open-angle glaucoma.When no systemic vascular disease is present in younger patients, the prognosis is known to be good. We experienced a case of CRVO with cilioretinal artery occlusion and open-angle glaucoma in young woman with one month treatment with thrombolytic agents, beta-blocker and carbonic anhydrase inhibitors. CRVO was resolved however intraocular pressure could not be controlled. She underwent trabeculectomy and then developed prolonged hypotony and hypotony maculopathy. It is not clear how long an eye can tolerate hypotony maculopathy before the visual loss is irreversible, but return of good vision has been reported when the overfiltration was reversed within 6 months of the onset of the complication. Hypotony state was sustained more than 8 months but hypotony maculopathy was resolved with visual improvement.
Subject(s)
Female , Humans , Arteries , Carbonic Anhydrase Inhibitors , Collagen , Dilatation , Edema , Fibrinolytic Agents , Glaucoma, Open-Angle , Hypertension , Intraocular Pressure , Prognosis , Retina , Retinal Hemorrhage , Retinal Vein , Trabeculectomy , Vascular Diseases , Visual AcuityABSTRACT
A cilioretinal artery occlusion associated with a central retinal vein occlusion is a rare condition and has been reported to have a good visual prognosis. We report a young patient with this condition who also demonstrated prolonged filling of the branch retinal arteries with fluorescein angiography. Her initial visual acuity was 0.03 in the affected eye. Two months later, normal central retinal artery inflow resumed. Her visual acuity has improved to 0.5 over the three years' follow-up.
Subject(s)
Humans , Arteries , Fluorescein Angiography , Follow-Up Studies , Prognosis , Retinal Artery , Retinal Vein , Visual AcuityABSTRACT
Blockage of the retinal artery system may occur in the form of central retinal arterial obstruction, branch retinal arterial obstruction, or combination of aforementioned. It may be related to known pre-existing systemic disease or it may be the initial manifestation of a previous undiagnosed systemic abnormality. The authors evaluatea the clinical course of 35 cases of retinal artery occlusion at Department of Ophthalmology, Pusan Paik Hospital Inje Mgdical College from September, 1979 to June, 1988.