Central retinal artery occlusion as initial presentation of Moyamoya disease in a middle-aged woman

Rajanala, Alekya; Le, Hong Gam T.; Gill, Manjot K.

doi:10.1016/j.ajoc.2020.100705

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…He was diagnosed with MMD with complete occlusion of the right ICA. A 48-year-old patient with CRAO reported by Rajanala et al 7 presented with hand motion vision in the right eye, which slightly improved to 20/2000 after 2 months of antiplatelet treatment for MMD. Ushimura et al 5 reported a pregnant woman with mitral valve prolapse who presented with CRAO, and MMD was diagnosed during evaluation.…”

Section: Resultsmentioning

confidence: 93%

“…Kumar and Ganesh, 10 Ushimura et al, 5 and Rajanala et al 7 reported adult patients with CRAO who were later diagnosed with MMD during systemic evaluation. Kumar and Ganesh 10 reported a 26-year-old patient with no previous medical history whose right eye vision dropped to light perception only because of CRAO.…”

Section: Resultsmentioning

confidence: 99%

“…3,4 Although MMD primarily affects the carotid artery in the ophthalmic artery bifurcation area, retinal vascular abnormalities have rarely been reported in MMD. [5][6][7][8][9][10][11][12][13] Until now, only a few cases on retinal artery occlusion (RAO) and retinal vein occlusion (RVO) have been reported. This study analyzed previously reported RAO and RVO cases along with three new cases of retinal vascular occlusion associated with MMD encountered at our institution.…”

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confidence: 99%

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Clinical Significance of Retinal Vascular Occlusion in Moyamoya Disease

Seong

Lee

Heo

et al. 2021

Retina

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Purpose: Although moyamoya disease primarily affects the carotid artery in the ophthalmic artery bifurcation area, retinal vascular abnormalities in moyamoya disease have rarely been reported. The purpose of this report is to describe clinical findings of patients with retinal vascular occlusion in patients with moyamoya disease and present its clinical significance. Methods: We reviewed and analyzed patients with moyamoya disease with retinal vascular occlusions. For this, a retrospective medical chart review was performed in a tertiary medical center and a literature search was performed using PubMed and EMBASE until September 2020. Results: Patients with retinal artery occlusion (RAO) were significantly younger than patients with retinal vein occlusion (25.0 vs. 40.1 years, P = 0.023). Of 14 patients, retinal vascular occlusion was the presenting sign of moyamoya disease in 8 (57.1%) patients. The occlusion site at the carotid artery was proximal to the ophthalmic artery bifurcation area in 8 (57.1%) patients. Legal blindness occurred in 8 (57.1%) patients at final visits. Conclusion: Retinal vascular occlusion is a rare but sight-threatening ocular complication in patients with moyamoya disease. Overall, younger age may be a risk factor for RAO, whereas older age for retinal vein occlusion. Retinal vascular occlusion can be an important indicator of moyamoya disease screening, especially in relatively younger and healthy patients.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical Significance of Retinal Vascular Occlusion in Moyamoya Disease

Seong

Lee

Heo

et al. 2021

Retina

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“…The links between retinal parameters and CeVD have been extensively evaluated ( Wong et al, 2001 , 2002 ; Couper et al, 2002 ; Mitchell et al, 2005 ; McGeechan et al, 2009 ; Cheung et al, 2010 ; Hanff et al, 2014 ; Rajanala et al, 2020 ). Three major groups of retinal changes have been connected to CeVD, namely, features of hypertensive retinopathy, clinical retinal diseases, and retinal microvascular abnormalities (including arteriovenous nicking, focal arteriolar narrowing, and decreased arteriole-to-venule ratio; Wong et al, 2001 ; Mitchell et al, 2005 ; Cheung et al, 2010 ; Hanff et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, retinal microvascular abnormalities are correlated with an increased risk of stroke and stroke mortality ( Wong et al, 2002 ). Longitudinal studies indicate that retinal vascular changes can predict patients at risk of progression to clinical CeVD ( McGeechan et al, 2009 ; Rajanala et al, 2020 ). However, most studies were conducted using retinal photography ( Wong et al, 2001 ; Couper et al, 2002 ; Mitchell et al, 2005 ; Cheung et al, 2010 ; Hanff et al, 2014 ), which cannot provide direct quantitative information on optic nerve structure and retinal vascular flow, and is less sensitive in the detection of retinal irregularities compared with optical coherence tomography (OCT; Goebel and Franke, 2006 ; Ouyang et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography Reveals Distinct Retinal Structural and Microvascular Abnormalities in Cerebrovascular Disease

et al. 2020

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Cerebrovascular disease (CeVD) is one of the leading global causes of death and severe disability. To date, retinal microangiopathy has become a reflection of cerebral microangiopathy, mirroring the vascular pathological modifications in vivo . To evaluate the retinal structure and microvasculature in patients with CeVD, we conducted a cross-sectional study in Zhongshan Ophthalmic Center and Department of Neurology of Third Affiliated Hospital, Sun Yat-sen University using optical coherence tomography angiography (OCTA). CeVD patients ( n = 121; 238 eyes) and healthy controls ( n = 44; 57 eyes) were included in the analysis. The CeVD group showed significant thinning of the peripapillary retinal nerve fiber layer (pRNFL) thickness in the temporal and nasal quadrants, and thinning of the macular ganglion cell-inner plexiform layer (GC-IPL) in the inferior quadrant, while macular microvasculature reduction was prominent in all nine quadrants. There were significant correlations between OCTA parameters, visual acuity, and transcranial doppler parameters in the CeVD group. The specific structural parameters combining microvasculature indices showed the best diagnostic accuracies (AUC = 0.918) to discriminate CeVD group from healthy controls. To conclude, we proved that OCTA reveals specific patterns of retinal structural changes and extensive macular microvascular changes in CeVD. Additionally, these retinal abnormalities could prove useful disease biomarkers in the management of individuals at high risk of debilitating complications from a cerebrovascular event.

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Sudden-onset unilateral vision loss in a young patient with a “cherry-red spot”

Thomas,

Gill

2025

Clinical Cases in Medical Retina

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Central retinal artery occlusion as initial presentation of Moyamoya disease in a middle-aged woman

Cited by 7 publications

References 5 publications

Clinical Significance of Retinal Vascular Occlusion in Moyamoya Disease

Clinical Significance of Retinal Vascular Occlusion in Moyamoya Disease

Optical Coherence Tomography Angiography Reveals Distinct Retinal Structural and Microvascular Abnormalities in Cerebrovascular Disease

Sudden-onset unilateral vision loss in a young patient with a “cherry-red spot”

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