Transient Monocular Visual Loss

Ahmed, Rafay; Foroozan, Rod

doi:10.1016/j.ncl.2010.03.004

Cited by 6 publications

(3 citation statements)

References 52 publications

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“…Visual disturbance might be the first symptom in younger patients without typical risk factors of vascular diseases. Another symptom characteristic for CADASIL, is transient loss of vision, which might be a result of ischemia caused by the embolism in ruptured atheroma of the internal carotid artery, heart, aorta or focal thrombosis of retinal vessels or posterior ciliary arteries [23,24]. Similar symptoms can be observed during vasospasm in association of hypercoagulability, migraines or giant-cell arthritis (GCA).…”

Section: Discussionmentioning

confidence: 99%

Ophthalmic Manifestations of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy

Modrzejewska¹,

Woźniak²,

Kaniewski³

2022

Preprint

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Aim of the study: Presentation of ophthalmic symptoms of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy (CADASIL). Material and methods: Clinical presentation of female patient with diagnosed CADASIL, manifested by transient loss of vision, migraine, convergence insufficiency, diplopia, increased deep tendon reflexes of upper left limb, subcortical infarcts, mood disturbances and dementia. Results: Confirmed NOTCH3 gene mutation (p.Cys212Gly), and presence of granular osmiophilic material (GOM) in cutaneous small vessel wall in immunohistochemistry laboratory test (IHC). Magnetic resonance imaging (MRI) revealed bilateral focal vasogenic lesions in white matter of cerebral hemisphere with single micro-focal infarct in the left external capsule. Furthermore, a left eye exophoria, a bilateral peripheral visual field loss of 20 degrees and a loss of nasolabial fold was confirmed during ophthalmic tests. An eye fundus examination as well as a fluorescein angiography (FA) revealed vessel constriction of retinal arteries and a peripheral retinal pigment epithelium (RPE) atrophy with focal drusen in the left eye. The doppler ultrasonography (USG) confirmed a decreased blood flow and an increased vascular resistance of the extraocular vessels. The pattern electroretinogram (PERG) revealed a reduced P50 wave amplitude in the patient’s left eye. Conclusions: intermittent blindness, migraine, convergence failure, diplopia with specific MRI signs, NOTCH3 mutation, and the presence of GOM in the skin of small blood vessels in a young or middle-aged patient suggests CADASIL. New observations include: atrophic changes in the RPE, hemodynamic disturbances in blood flow in the short posterior ciliary arteries and in the central retinal artery, single drusen in the retina, and a reduced amplitude of the P50 wave in PERG.

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Section: Discussionmentioning

confidence: 99%

Ophthalmic Manifestations of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy

Modrzejewska¹,

Woźniak²,

Kaniewski³

2022

Preprint

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“…Amaurosis fugax is one of the most serious causes and results from an embolus affecting the retinal circulation, usually arising from a carotid artery atherosclerotic plaque or, rarely, from cardiac valvular disease, the aorta or an internal carotid dissection. 6 Assessment for atrial fibrillation is essential, and electrocardiography (ECG) and a Holter monitor test should be performed, along with assessment of the carotids by Doppler ultrasonography.…”

Section: Monocular Transient Vision Lossmentioning

confidence: 99%

Blackout: Understanding transient vision loss

Jeffery

Chen

Lueck³

2021

Aust J Gen Pract

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“…In contrast, transient monocular vision loss (TMVL) is commonly associated with giant cell arteritis (GCA), retinal artery occlusion, and thromboembolic events [ 2 ]. A proper history into the timing, pattern, triggering factors, and accompanying symptoms frequently offers insights into determining the underlying cause of the episode [ 3 ]. Klippel–Feil syndrome (KFS), first described by Maurice Klippel and Andre Feil in 1912, is a rare congenital bone disorder distinguished by abnormal fusion of two or more cervical spine vertebrae [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Transient binocular vision loss and pain insensitivity in Klippel–Feil syndrome: a case report

Ullah,

Zafar,

Ishaq

et al. 2024

J Med Case Reports

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Background Klippel–Feil syndrome is a rare congenital bone disorder characterized by an abnormal fusion of two or more cervical spine vertebrae. Individuals with Klippel–Feil syndrome exhibit diverse clinical manifestations, including skeletal irregularities, visual and hearing impairments, orofacial anomalies, and anomalies in various internal organs, such as the heart, kidneys, genitourinary system, and nervous system. Case presentation This case report describes a 12-year-old Pashtun female patient who presented with acute bilateral visual loss. The patient had Klippel–Feil syndrome, with the typical clinical triad symptoms of Klippel–Feil syndrome, along with Sprengel’s deformity. She also exhibited generalized hypoalgesia, which had previously resulted in widespread burn-related injuries. Upon examination, bilateral optic disc swelling was observed, but intracranial pressure was found to be normal. Extensive investigations yielded normal results, except for hypocalcemia and low vitamin D levels, while parathyroid function remained within the normal range. Visual acuity improved following 2 months of calcium and vitamin D supplementation, suggesting that the visual loss and optic nerve swelling were attributed to hypocalcemia. Given the normal parathyroid function, it is possible that hypocalcemia resulted from low vitamin D levels, which can occur after severe burn scarring. Furthermore, the patient received a provisional diagnosis of congenital insensitivity to pain on the basis of the detailed medical history and the findings of severe and widespread loss of the ability to perceive painful stimuli, as well as impaired temperature sensation. However, due to limitations in genetic testing, confirmation of the congenital insensitivity to pain diagnosis could not be obtained. Conclusion This case highlights a rare presentation of transient binocular vision loss and pain insensitivity in a patient with Klippel–Feil syndrome, emphasizing the importance of considering unusual associations in symptom interpretation.

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Transient Monocular Visual Loss

Cited by 6 publications

References 52 publications

Ophthalmic Manifestations of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy

Ophthalmic Manifestations of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infracts and Leucoencephalopathy

Blackout: Understanding transient vision loss

Transient binocular vision loss and pain insensitivity in Klippel–Feil syndrome: a case report

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