Echocardiographic Findings of Patients With Retinal Ischemia or Embolism

Mouradian, Mikael S.; Wijman, Christine A.C.; Tomasian, Douglas; Davidoff, Ravin; Koleini, Behrooz; Babikian, Viken L.

doi:10.1177/10528402012003002

Cited by 3 publications

(1 citation statement)

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“…Cardiogenic emboli are a very rare cause of CRAO. While atrial fibrillation and left ventricular dysfunction were shown to be the most common cardiac sources, extracardiac sources (mainly aortic and carotid plaques) are associated with CRAO in the large majority of patients 1 . Unfortunately, the source of embolism remains unclear in about 45% of the patients 2 .…”

Section: Discussionmentioning

confidence: 99%

Lesions of the Mitral Valve as a Cause of Central Retinal Artery Occlusion: Presentation and Discussion of Two Cases

2010

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We present two cases of mitral valve lesions that manifested with unilateral blindness caused by central retinal artery occlusion (CRAO): Case 1. A 68-year-old woman was admitted to our clinic for sudden blindness. Retinal artery angiogram showed CRAO. Transthoracic and transesophageal echocardiography (TEE) documented a mass attached to the ventricular side of the posterior mitral leaflet, which at pathology was identified as a blood cyst. Case 2. A 67-year-old man was admitted for a sudden unilateral painless loss of vision. Retinal angiogram documented CRAO, and TEE showed a highly mobile, spherical, lesion on the atrial side of anterior mitral leaflet. In this case, the pathological finding was a degenerated calcified thrombosis. We report on two cases of very rare abnormalities of the mitral valve presenting with a very rare embolic complication, i.e., CRAO. Like for cryptogenic stroke, transesophageal echocardiography plays a central role in the diagnosis of cardiogenic embolic sources.

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Section: Discussionmentioning

confidence: 99%

Lesions of the Mitral Valve as a Cause of Central Retinal Artery Occlusion: Presentation and Discussion of Two Cases

2010

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Central retinal artery occlusion associated with persistent truncus arteriosus and single atrium: a case report

Wang

Zhou

et al. 2015

BMC Ophthalmol

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BackgroundCentral retinal artery occlusion (CRAO) is an ocular emergency and most of the cases present with painless sudden persistent loss of vision in the range of counting fingers to perception of light. The presentation of CRAO is associated with a variety of medical conditions. We report a rare case of CRAO associated with persistent truncus arteriosus (PTA) and single atrium in a female patient.Case presentationA 23-year-old woman was admitted due to sudden painless visual loss in the left eye. On examination visual acuity of light-perception was noted in the left eye with a left relative afferent pupillary defect. Fundoscopic examination revealed retinal ischemic whitening, constriction of the arteriole and venule with segmentation and typical “cherry-red spot” suggesting CRAO. The patient was treated with ocular massage and anterior chamber paracentesis. She was commenced on 150 mg of aspirin and also received hyperbaric oxygen therapy. An echocardiogram revealed PTA and single atrium. A diagnosis of CRAO associated with PTA and single atrium was made.ConclusionThe ophthalmologist should enquire about congenital and acquired cardiac abnormalities in patients with CRAO and consider such abnormalities to be possible sources of emboli.

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The Effects of Hyperbaric Oxygen Therapy in Patients with Central Retinal Artery Occlusion: A Retrospective Study, Systematic Review, and Meta-analysis

Rosignoli¹,

Chu²,

Carter³

et al. 2022

Korean J Ophthalmol

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Purpose: Central retinal artery occlusion (CRAO) is a vision-threatening condition with a potentially poor visual prognosis. Many different treatment modalities are suggested but controversy remains regarding effectiveness of these treatments. The purpose of this study is to perform a systematic review and meta-analysis in addition to analyzing retrospective data at our own tertiary care center regarding effectiveness of hyperbaric oxygen therapy (HBOT) in treatment of CRAO.Methods: The PubMed, Scopus, and the Cochrane Library are searched from the date of database inception to September 2021 to conduct a review based on the PRISMA (preferred reporting items for systematic review and meta-analysis), evaluating the role of HBOT in visual recovery of CRAO patients. In addition, a retrospective chart review of patients clinically diagnosed with CRAO at our university-based hospital (University of Texas Health, San Antonio, TX, USA) from year 2011 to 2021 was conducted.Results: After a review of 376 articles, three articles met the inclusion criteria for meta-analysis, where a total of 207 patients received HBOT versus 89 patients that did not receive any form of oxygen therapy. Analysis of these results demonstrate that HBOT in CRAO patients does not enhance the final visual outcome (p; = 0.83). Similar conclusion was also drawn from retrospective analysis of 48 patients (15 HBOT versus 33 controls) at our tertiary care center, where no visual benefit was observed in the HBOT group.Conclusions: HBOT does not appear to improve final visual outcome and concerns remain regarding adverse reactions such as barotrauma and generalized seizures. Large, randomized studies are required for further understanding of the role of HBOT in treatment of CRAO.

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Echocardiographic Findings of Patients With Retinal Ischemia or Embolism

Abstract: Echocardiography frequently identifies lesions of the heart or aortic arch that can act as potential sources for retinal ischemia or embolism. Further studies are needed to evaluate the prognostic and therapeutic relevance of these findings.

Cited by 3 publications

References 0 publications

Lesions of the Mitral Valve as a Cause of Central Retinal Artery Occlusion: Presentation and Discussion of Two Cases

Lesions of the Mitral Valve as a Cause of Central Retinal Artery Occlusion: Presentation and Discussion of Two Cases

Central retinal artery occlusion associated with persistent truncus arteriosus and single atrium: a case report

The Effects of Hyperbaric Oxygen Therapy in Patients with Central Retinal Artery Occlusion: A Retrospective Study, Systematic Review, and Meta-analysis

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