Amaurosis fugax associated with antiphospholipid antibodies

Digre, Kathleen B.; Durcan, F. Jane; Branch, D. Ware; Jacobson, Dan; Varner, Michael W.; Baringer, J. Richard

doi:10.1002/ana.410250304

Cited by 88 publications

(22 citation statements)

References 31 publications

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“…This relatively high percentage is not different from the 45.3% of cerebral infarcts of unknown cause observed in the Stroke Data Bank project [13], and it compares favorably with the findings of another study of retinal arterial occlusive disease [7]. Because detailed hematological evaluations were not obtained systematically in this study, it is possible that some patients in this subgroup suffered from hypercoagulable states [14, 15, 16]. Furthermore, transesophageal echocardiography was obtained in only 18.2% patients, so that some cardiac or aortic arch lesions may have been missed.…”

Section: Discussionmentioning

confidence: 68%

Retinal Ischemia and Embolism

et al. 2001

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Objectives: To identify the most likely mechanisms of retinal ischemia and embolism in a hospital-referred population, and to determine the frequency of recurrent vascular events during the 3-month period following initial presentation. Methods: Consecutive patients presenting to 2 tertiary medical centers and their outpatient clinics were prospectively enrolled over a 22-month period. Eligible patients presented with histories of transient or permanent monocular visual loss, or had evidence of asymptomatic retinal embolism on routine ophthalmological examination. They underwent a rapid and standardized evaluation that included imaging studies as well as blood tests, and follow-up was obtained at 1 and 3 months. Results: Seventy-seven patients were enrolled. Enrollment diagnoses consisted of amaurosis fugax (n = 32), asymptomatic retinal embolism (n = 34), and central or branch retinal artery occlusion (n = 11). Eight different presumed etiologies of retinal artery distribution embolism or hypoperfusion were identified. Extracranial internal carotid artery occlusion or more than 50% stenosis was observed in 17/77 (22.1%) cases, making it the largest etiologic subgroup. Uncommon but treatable conditions were identified in 8/77 (10.4%) patients, and an etiologic diagnosis could not be made in 35/77 (45.5%) patients. Recurrent events occurred in, respectively, 14/77 (18.2%) and 6/73 (8.2%) patients at the 1- and 3-month follow-ups. They included 2 infarcts and 2 deaths; ischemic events of the retina were more common than those involving the brain. Conclusion: Severe stenosis of the extracranial internal carotid artery is the most common identified condition associated with retinal ischemia and embolism, but a variety of other, potentially treatable, conditions can be diagnosed if appropriate and specific evaluations are conducted. The frequency of recurrent vascular ischemic events is highest during the 1st month of follow-up and decreases during the 2nd and 3rd months. Recurrences range from relatively innocuous episodes of amaurosis fugax to vascular death.

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Section: Discussionmentioning

confidence: 68%

Retinal Ischemia and Embolism

et al. 2001

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“…Likewise, several studies have reported the existence of a link between aPL and seizures in patients with SLE or in patients with the primary syndrome (11,12). Ocular disturbances (amaurosis fugax [2,13] and optic atrophy [2]), multiinfarct dementia, dementia of nonischemic origin (6,14,15), and chorea (16) have also been reported in patients with primary APS. Controversial reports exist regarding a similar association with nonspecific and migraine headaches (17,18), transverse myelitis (3,19), and Guillain-Barre syndrome (20).…”

Section: Introductionmentioning

confidence: 97%

Neurological dysfunction and hyperactive behavior associated with antiphospholipid antibodies. A mouse model.

Ziporen¹,

Shoenfeld²,

Levy³

et al. 1997

J. Clin. Invest.

117

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“…Occasionally, the visual disturbance resembles the temporary loss of contrast vision typical of type II or the photopsias and scintillations of vasospastic type III. In several studies and in our own experience, no cause has been found to explain recurrent TMB type IV in young adults, apart from observations by Digre et al, 12 which document the association of TMB type IV in patients with anticardiolipin antibodies.…”

Section: Transient Monocular Blindness Type IVmentioning

confidence: 50%