Central Retinal Artery Occlusion in a Patient With Fibromuscular Dysplasia

Sawada, Tatsu; Harino, Seiyo; Ikeda, Tsunehiko

doi:10.1097/00006982-200406000-00023

Cited by 14 publications

(7 citation statements)

References 5 publications

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“….). 11,[14][15][16][17] Cilioretinal artery can also be occluded, as reported by Warrasak et al 6 This case is the only case report to date that describes the string-of-beads pattern in the retinal vasculature, as well as in our patient 1 (Figure 2(f)). Additionally, hemorrhagic complications such as optic nerve sheath and diffuse retinal hemorrhages can occur secondary to subarachnoid hemorrhage from a ruptured intracranial aneurysm.…”

Section: Discussionsupporting

confidence: 78%

Ocular ischemic manifestations in fibromuscular dysplasia

Artieda

Cabrejas

Sánchez-Muros

et al. 2021

European Journal of Ophthalmology

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Purpose: To report visual, clinical and radiological outcomes of three patients with fibromuscular dysplasia (FMD) that presented different ocular ischemic events, supported by different multimodal imaging. Methods: A retrospective study including patients who attended a tertiary referral hospital from July 2016 to June 2019 referring acute visual loss and later diagnosed of FMD. Ophthalmological examination included best corrected visual acuity (BCVA), biomicroscopy, fundoscopy, fluorescein angiography (FA), and macular and retinal nerve fiber layer spectral domain optic coherence tomography (SD-OCT). Patients were admitted by the Neurology service, completing the study with blood and cerebrospinal fluid (CSF) test, serology and cultures, cerebral magnetic resonance angiography (angioMRI), and arteriography. Results: Three patients were included; one male and second females. All referred unilateral acute visual loss, with BCVA of counting fingers or hand-motion. Relative afferent pupilar defect was present in all patients. Two patients associated neurological focal signs and one had chronic hypertension. Fundoscopy revealed hemorrhages and exudates in all patients, and the typical sign of “string-of-beads” in one. FA showed dye filling delay and macular and peripheral hypofluorescence. SD-OCT revealed acute and chronic retinal ischemic signs. Blood and CSF tests, serologies and cultures resulted negative. All presented cerebral vascular involvement, objectified in the cerebral angioMRI or arteriography. Conclusions: FMD should be considered in cases with unilateral sudden visual loss associated to neurological focal deficits in young patients. The typical “string-of-beads” image is rare in small arteries such as the retinal vasculature. When suspected, a complete ophthalmological examination and cerebral vascular imaging is essential to confirm the diagnosis.

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Section: Discussionsupporting

confidence: 78%

Ocular ischemic manifestations in fibromuscular dysplasia

Artieda

Cabrejas

Sánchez-Muros

et al. 2021

European Journal of Ophthalmology

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“…Two possible etiologies of such proximal obstruction to consider are arterial dissection and occlusive fibromuscular dysplasia, both of which have previously been implicated in the pathogenesis of central retinal artery occlusion. 12,13 Indeed, these commenters have recently diagnosed a fibromuscular dysplasia-related central retinal artery occlusion in a patient 3 weeks postpartum with clinical features very similar to those described in this case, including the presence of a cherry red spot, central capillary nonperfusion, and abrupt truncation of multiple arterioles with late leakage from involved vessels.…”

supporting

confidence: 57%

Diagnostic and Therapeutic Challenges

Hill¹,

Skelley²,

Pomerleau³

et al. 2013

Retina

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“…FMD of the retinal artery is rare in literature 5,13,14. We present a case of central artery occlusion in a girl who already had the diagnosis of FMD.…”

Section: Discussionmentioning

confidence: 89%

Central retinal artery occlusion in association with fibromuscular dysplasia

Altun¹,

Altun²,

Olcaysu³

et al. 2013

OPTH

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A 14 year-old female, whose chief complaint was severe vision loss in the right eye for 2 days, presented to the Clinic of Ophthalmology of Fatih Sultan Mehmet Education and Research Hospital. The patient had been attending follow-up visits for 4 years, following a diagnosis of fibromuscular dysplasia by the Clinic of Pediatrics. The patient underwent a complete ophthalmo-logic, angiographic, hematologic, and systemic evaluation. Fundus fluorescein angiography was performed immediately, because of the cherry-red spot sign in the macula of the right eye. Fundus fluorescein angiography revealed evidence of marked stasis of the retinal arterial circulation in the right eye. Best corrected visual acuity was 20/400 in the right eye and 20/20 in the left eye.

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Central Retinal Artery Occlusion in a Patient With Fibromuscular Dysplasia

Cited by 14 publications

References 5 publications

Ocular ischemic manifestations in fibromuscular dysplasia

Ocular ischemic manifestations in fibromuscular dysplasia

Diagnostic and Therapeutic Challenges

Central retinal artery occlusion in association with fibromuscular dysplasia

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