Les plus populaires - Cilioretinal Artery Occlusion - Chronic - Posterior Ciliary Artery Occlusion - Choroidal Ischemia / Infarct 80-year-old woman was seen in the office on 10/26/2010. She notices a cloud in the middle of the vision in the left eye. She says she was looking in the mirror without her glasses on and she noticed things were a little blurred. She covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She did have a history of vision loss in the right eye which was transient and from transient ischemic attacks in 1995. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. She is scheduled for a carotid study in the near future.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/200. IOP: 17 in both eyes.
SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is a posterior vitreous separation. There are rare macular drusen.
OS: Vertical C/D ratio is 0.5. There is 1+ pallor of the optic nerve. There is no posterior vitreous separation. There is a prominent cilioretinal artery feeding the inferior half of the macula which is where her visual complaint is. There is no retinal whitening though and there is no evidence of any emboli.
OCT SCAN: The OCT scan of the optic nerve shows nerve fiber layer thinning in each eye with the right eye at 88 and the left eye 91 and there is segmental inferior pallor of the optic nerve.
FLUORESCEIN ANGIOGRAPHY: FA shows poor filling of the cilioretinal artery in the left eye and the choroid in the left eye.
IMPRESSION:
1. CILIORETINAL ARTERY OCCLUSION – LEFT EYE - Possible Ophthalmic Artery Occusion sparing CRA.
2. INFERIOR OPTIC ATROPHY – BOTH EYES
3. HISTORY OF TRANSIENT ISCHEMIC ATTACK – RIGHT EYE
DISCUSSION: I explained to the patient she has had a blockage in one of the main retinal vessels in the left eye which unfortunately has damaged her central vision. At this moment there is no treatment for retinal vascular occlusions, but fortunately the odds are that things will not become any worse. She is already taking a baby aspirin a day. She does need to be evaluated for stroke risks and I will send a letter to her medical doctor to ask him to follow-up with that as well as to check her for possible giant cell arteritis.
The optic nerves do look a little pale and this is suspicious for low-tension glaucoma.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 1241 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 907 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 867 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 851 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 842 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 789 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 778 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 750 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 719 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 716 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 712 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 710 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 671 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 632 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 600 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 592 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 583 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 580 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 564 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Arteryvu 524 fois80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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80-year-old woman was seen in the office on 10/26/2010. She notices a cloud in the middle of the vision in the left eye. She says she was looking in the mirror without her glasses on and she noticed things were a little blurred. She covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She did have a history of vision loss in the right eye which was transient and from transient ischemic attacks in 1995. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. She is scheduled for a carotid study in the near future.
VISUAL ACUITY: Vision OD is 20/40, OS is 20/200. IOP: 17 in both eyes.
SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is a posterior vitreous separation. There are rare macular drusen.
OS: Vertical C/D ratio is 0.5. There is 1+ pallor of the optic nerve. There is no posterior vitreous separation. There is a prominent cilioretinal artery feeding the inferior half of the macula which is where her visual complaint is. There is no retinal whitening though and there is no evidence of any emboli.
OCT SCAN: The OCT scan of the optic nerve shows nerve fiber layer thinning in each eye with the right eye at 88 and the left eye 91 and there is segmental inferior pallor of the optic nerve.
FLUORESCEIN ANGIOGRAPHY: FA shows poor filling of the cilioretinal artery in the left eye and the choroid in the left eye.
IMPRESSION:
1. CILIORETINAL ARTERY OCCLUSION – LEFT EYE - Possible Ophthalmic Artery Occusion sparing CRA.
2. INFERIOR OPTIC ATROPHY – BOTH EYES
3. HISTORY OF TRANSIENT ISCHEMIC ATTACK – RIGHT EYE
DISCUSSION: I explained to the patient she has had a blockage in one of the main retinal vessels in the left eye which unfortunately has damaged her central vision. At this moment there is no treatment for retinal vascular occlusions, but fortunately the odds are that things will not become any worse. She is already taking a baby aspirin a day. She does need to be evaluated for stroke risks and I will send a letter to her medical doctor to ask him to follow-up with that as well as to check her for possible giant cell arteritis.
The optic nerves do look a little pale and this is suspicious for low-tension glaucoma.
