Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes
Purpose: To introduce a case of bilateral retinal artery occlusions with carotid occlusions to achieve a fuller understanding of hemodynamic flow changes and the origin of emboli. Observations: A 58-year-old male presented with binocular vision loss. Fundus examination revealed bilateral retinal whi...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993620302747 |
| _version_ | 1818392688069705728 |
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| author | San-Ni Chen Jeff Huang Jiunn-Feng Hwang |
| author_facet | San-Ni Chen Jeff Huang Jiunn-Feng Hwang |
| author_sort | San-Ni Chen |
| collection | DOAJ |
| description | Purpose: To introduce a case of bilateral retinal artery occlusions with carotid occlusions to achieve a fuller understanding of hemodynamic flow changes and the origin of emboli. Observations: A 58-year-old male presented with binocular vision loss. Fundus examination revealed bilateral retinal whitening with multiple emboli. Cherry red spot was surrounded and shaped by white edematous ischemic retina. FAG showed retinal refilling but not to the macula and choroidal background. Carotid arteriography and color Doppler images demonstrated bilateral carotid occlusions. CT angiography showed compensatory flows perfused from vertebral arteries for the brain. Orbital color Doppler images revealed bilateral reversed ophthalmic flows indicating another compensatory flow arising from external carotid/ophthalmic collaterals to both eyes. Conclusions and Importance: Reversed ophthalmic flow indicates the presence of external carotid/ophthalmic collaterals as the source of ocular blood supply and the origin of emboli. In this case, all the embolic, hemodynamic, and serotonin mechanisms may be responsible for the pathogenesis. RAO with multiple emboli is an important sign warning critical flow changes of carotid occlusions. |
| first_indexed | 2024-12-14T05:33:23Z |
| format | Article |
| id | doaj.art-7affeba51fde4d4686f6135109f5ec1a |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-14T05:33:23Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-7affeba51fde4d4686f6135109f5ec1a2022-12-21T23:15:16ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-12-0120100959Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changesSan-Ni Chen0Jeff Huang1Jiunn-Feng Hwang2Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan; College of Medicine, Chung-Shan Medical University, Taichung, Taiwan; Department of Optometry, College of Nursing and Health Sciences, Da-Yeh University, Changhua, TaiwanCentre for Neuroscience Studies, Queen's University, Kingston, Ontario, CanadaDepartment of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan; Corresponding author. M.D. Department of Ophthalmology, Chang-Hua Christian Hospital, 135 Nan-Siao St. Chang-Hua, 500, Taiwan, .Purpose: To introduce a case of bilateral retinal artery occlusions with carotid occlusions to achieve a fuller understanding of hemodynamic flow changes and the origin of emboli. Observations: A 58-year-old male presented with binocular vision loss. Fundus examination revealed bilateral retinal whitening with multiple emboli. Cherry red spot was surrounded and shaped by white edematous ischemic retina. FAG showed retinal refilling but not to the macula and choroidal background. Carotid arteriography and color Doppler images demonstrated bilateral carotid occlusions. CT angiography showed compensatory flows perfused from vertebral arteries for the brain. Orbital color Doppler images revealed bilateral reversed ophthalmic flows indicating another compensatory flow arising from external carotid/ophthalmic collaterals to both eyes. Conclusions and Importance: Reversed ophthalmic flow indicates the presence of external carotid/ophthalmic collaterals as the source of ocular blood supply and the origin of emboli. In this case, all the embolic, hemodynamic, and serotonin mechanisms may be responsible for the pathogenesis. RAO with multiple emboli is an important sign warning critical flow changes of carotid occlusions.http://www.sciencedirect.com/science/article/pii/S2451993620302747Retinal artery occlusionEmboliCarotid occlusionCherry red spot |
| spellingShingle | San-Ni Chen Jeff Huang Jiunn-Feng Hwang Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes American Journal of Ophthalmology Case Reports Retinal artery occlusion Emboli Carotid occlusion Cherry red spot |
| title | Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes |
| title_full | Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes |
| title_fullStr | Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes |
| title_full_unstemmed | Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes |
| title_short | Bilateral retinal artery occlusions with carotid artery occlusions-ocular and cerebral hemodynamic changes |
| title_sort | bilateral retinal artery occlusions with carotid artery occlusions ocular and cerebral hemodynamic changes |
| topic | Retinal artery occlusion Emboli Carotid occlusion Cherry red spot |
| url | http://www.sciencedirect.com/science/article/pii/S2451993620302747 |
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