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Occlusion of the Ophthalmic Artery

Occlusion of Ophthalmic Artery


Presentation

  • CASE PRESENTATION: A 22-year-old African gentleman presented with left nasal obstruction and epistaxis for 2 years and was diagnosed with nasopharyngeal carcinoma.[ncbi.nlm.nih.gov]
  • In light of the present case, ophthalmic artery occlusion may be a rare feature of neurofibromatosis type I besides more commonly described cerebrovascular changes.[ncbi.nlm.nih.gov]
  • Abstract A 75-year-old man presented to us with sudden onset of profound vision loss in his right eye and was identified as suffering from an ophthalmic artery occlusion.[ncbi.nlm.nih.gov]
  • A case of multiple branch retinal artery occlusions in a 63-year-old male with internal carotid artery and ophthalmic artery occlusions on brain angiography is presented.[ncbi.nlm.nih.gov]
  • When both were present angiographically, PI was higher than in the group with only 1 Willisian collateral.[ncbi.nlm.nih.gov]
Collapse
  • The aneurysm was collapsed by gentle aspiration through the distal lumen of the balloon catheter. This greatly facilitated dissection and clip ligation of the aneurysm.[ncbi.nlm.nih.gov]
Vascular Disease
  • Theme 7 Retinal Vascular Diseases Occlusion of the retinal arteries or veins produces retinal ischemia and visual loss.[neuro-ophthalmology.stanford.edu]
  • Henkind E Retinal vascular disease: introduction and phenomenology. Trans Am Acad Ophthalmol Otolaryngol 1977;83:367-372. 5. Rehany U, Kassif Y, Rumelt S.[healio.com]
  • A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA 1995;274:1049-57. 10. Al Wadani F, Khandekar R, Salim G, Al Ali M, Ramzi S.[ojoonline.org]
Freckles
  • Abstract Etiological investigation of a 15-year-old boy with left ophthalmic artery occlusion led us to a diagnosis of neurofibromatosis type I as there were numerous large cafe-au-lait spots, axillary freckling, and brain MRI changes consistent with[ncbi.nlm.nih.gov]
Cafe-Au-Lait Spots
  • Abstract Etiological investigation of a 15-year-old boy with left ophthalmic artery occlusion led us to a diagnosis of neurofibromatosis type I as there were numerous large cafe-au-lait spots, axillary freckling, and brain MRI changes consistent with[ncbi.nlm.nih.gov]
Axillary Freckling
  • Abstract Etiological investigation of a 15-year-old boy with left ophthalmic artery occlusion led us to a diagnosis of neurofibromatosis type I as there were numerous large cafe-au-lait spots, axillary freckling, and brain MRI changes consistent with[ncbi.nlm.nih.gov]
Suggestibility
  • These findings suggest that OAC has a marginal effect on vascular resistance in arterial bed distal to an ICAO, while Willisian collaterals appear to have a more important role in cerebral perfusion, as measured indirectly by Doppler methods.[ncbi.nlm.nih.gov]
  • These findings suggest that OAC has a marginal effect on vascular resistance in arterial bed distal to an ICAO, while Willisian collaterals appear to have a more important role in cerebral perfusion, as measured indirectly by Doppler methods. 1990 by[neurology.org]
  • The possible mechanisms contributing to the loss of vision are discussed and preventive strategies are suggested to reduce the incidence of this complication.[ncbi.nlm.nih.gov]
  • Their findings suggest that in cases of extracranial carotid artery occlusion, the forward ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA occlusion and from the branches of the ipsilateral external carotid artery in cases[ncbi.nlm.nih.gov]
  • The cerebral angiographic findings also suggest that the angiographic runoff is diminished in the distal branches of internal maxillary arteries only in hyaluronic acid injected group.[iovs.arvojournals.org]
Epistaxis
  • CASE PRESENTATION: A 22-year-old African gentleman presented with left nasal obstruction and epistaxis for 2 years and was diagnosed with nasopharyngeal carcinoma.[ncbi.nlm.nih.gov]
Wide Neck
  • Balloon-assisted coiling was elected to attempt dense packing of the wide necked aneurysm. A 75 mg of clopidogrel and a 100 mg of aspirin were administered 4 days before the procedure.[jstage.jst.go.jp]

Workup

  • […] in younger patients 6 and an embolic workup in older patients.[aao.org]
  • Systemic workup should include an evaluation for those abnormalities associated with acute CRAO. From there your doctor will recommend a course of ocular therapy.[williamsoneyeinstitute.com]
  • In young patients a vasculitis and/or hypercoagulable workup should be performed. In older patients, an embolic workup should be performed.[eyewiki.aao.org]
  • […] carotid disease, and other sources of emboli are classic causes of retinal ischemia (see Table 7.2). 7.1.3 Treatment of Acute Retinal Arterial Ischemia Acute treatment consists of the following: Patients seen acutely should be admitted for immediate workup[neuro-ophthalmology.stanford.edu]
  • Ophthalmic/retinal vascular occlusion (RVO) suggested an underlying systemic disease and recommended workup of a patient with RVO is suggested in [Table 3].[ojoonline.org]

Treatment

  • After treatment with aspirin, attacks resolved completely. Her symptoms were attributed to microembolism from the occluded OA.[ncbi.nlm.nih.gov]
  • Three weeks after treatment, the angiographic abnormalities had resolved, and the retinal and choroidal circulations were normal. Twenty-eight months after treatment, the visual acuity was 20/20 in each eye.[ncbi.nlm.nih.gov]
  • Prospective randomized multicenter clinical trial in Europe to compare treatment outcome after conservative standard treatment with LIF using recombinant tissue plasminogen activator for patients with CRAO within 20 h after the onset was stopped after[jstage.jst.go.jp]
  • CONCLUSIONS: Combined parent artery and ophthalmic artery occlusion is an effective treatment for a giant aneurysm located between the ophthalmic artery and the posterior communicating artery.[ncbi.nlm.nih.gov]
  • Abstract The Pipeline Embolization Device (PED) is a flow diverting stent used in the treatment of a wide variety of intracranial aneurysms.[ncbi.nlm.nih.gov]

Prognosis

  • Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction.[ncbi.nlm.nih.gov]
  • Interestingly, autologous fat injection was associated with a worse visual prognosis and a higher incidence of combined cerebral infarction.[evrs.eu]
  • J Neurol Neurosurg Psychiatry 76: 196–199, 2005 20) Augsburger JJ, Magargal LE: Visual prognosis following treatment of acute central retinal artery obstruction.[jstage.jst.go.jp]
  • This vision loss is usually dramatic and permanent and the prognosis is poor.[uhms.org]
  • The amount of retinal edema is related to visual prognosis. [7] Over the course of about 1 month, the inner retinal becomes atrophic and thins.[eyewiki.aao.org]

Etiology

  • Abstract Etiological investigation of a 15-year-old boy with left ophthalmic artery occlusion led us to a diagnosis of neurofibromatosis type I as there were numerous large cafe-au-lait spots, axillary freckling, and brain MRI changes consistent with[ncbi.nlm.nih.gov]
  • (III, good quality, strong recommendation) Acute, symptomatic OAO or CRAO from embolic etiologies should prompt an immediate referral to the nearest stroke referral center for prompt assessment for consideration of an acute intervention.[aao.org]
  • Subsequent management is directed toward identification and treatment of any underlying disease, with etiologic considerations being similar to those for central retinal artery occlusion.[healio.com]
  • The etiology of the arterial occlusion (thrombosis, embolus, arteritis, vasospasm) has also been described as affecting outcome.(4,5) Careful classification of the factors involved in an individual case of CRAO is crucial to understanding the natural[uhms.org]
  • […] atrial myxoma [5] and as a complication of prolonged surgery under general anesthesia especially neuro/spinal surgery. [6] In a previous report, Ganesh et al. described spontaneous ophthalmic artery occlusion in a 7-year-old girl without any underlying etiology[ojoonline.org]

Epidemiology

  • Retinal arteriolar emboli: epidemiology and risk of stroke. Curr Opin Ophthalmol 2002; 13: 142–146. PubMed Crossref Google Scholar [34] Wong TY, Larsen EK, Klein R, et al.[degruyter.com]
  • Devauchelle-Pensec V, Jousse S, Destombe C, Saraux A (2008) Epidemiology, imaging and treatment of giant cell arteritis. Joint Bone Spine 75:267–272 CrossRef PubMed Google Scholar 11.[link.springer.com]
  • FACS, 6 1 Emory Eye Center, Emory University, Atlanta, Georgia 2 Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 3 Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa 4 Division of Epidemiology[aao.org]
  • Epidemiology The true incidence of CRAO in the population is unknown. Rumelt 1999 estimated an incidence of acute (less than 48 hours) CRAO of 0.85/100,000 population/year at their institution.[cochranelibrary.com]
Sex distribution
Age distribution

Pathophysiology

  • ProCite RefWorks Reference Manager ARVO (1962-2015); The Authors (2016-present) Supplements Abstract Purpose To evaluate the angiographic features of cosmetic facial filler associated ophthalmic artery and its branches occlusion, thereby elucidate its pathophysiology[iovs.arvojournals.org]
  • Pathophysiology The central retinal artery supplies the inner retina. Occlusion of the retinal arteries results in ischemia of the inner retina. When the inner retina is damaged, it first becomes very edematous.[eyewiki.aao.org]

Prevention

  • CONCLUSION: Pre-operative angio-architecture understanding and diligent selection of embolic material are helpful in preventing this adverse event.[ncbi.nlm.nih.gov]
  • This case highlights the importance of early diagnosis and prompt treatment of giant cell arteritis in order to prevent the blinding complications like ophthalmic artery occlusion, and in case of unilateral involvement, to save the other eye.[ijmr.org.in]
  • The possible mechanisms contributing to the loss of vision are discussed and preventive strategies are suggested to reduce the incidence of this complication.[ncbi.nlm.nih.gov]
  • Awareness of the iatrogenic artery occlusions associated with facial fillers and the need for immediate treatment should be popularized among injectors to prevent devastating consequences, such as permanent vision loss.[ncbi.nlm.nih.gov]
  • Atlanta, Georgia 2 Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 3 Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa 4 Division of Epidemiology, Department of Family, Population and Preventive[aao.org]

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