Purpose: This case report describes the delayed, uncommon ophthalmic presentations of monocular choroidal ischemia (Amalric triangular sign), ischemic optic neuropathy, central retinal artery occlusion (CRAO), and extraocular motility restriction caused by traumatic internal carotid artery dissection (ICAD) in a young individual.
Observations: A 29-year-old man presented with sudden vision loss in his left eye which had started 7 h earlier. His medical history included a motorcycle accident six months prior, where he struck his chin on the ground and lost consciousness. At that time, he had completely recovered with no complications. On the day the patient reported with vision problem, an ophthalmic examination of the affected eye revealed visual acuity of no perception of light (NPL), restriction of extraocular movement, and relative afferent pupillary defect. Fundus examination showed slightly pale optic disc swelling, macular whitening with a cherry red spot appearance indicating the presence of CRAO, and several whitish triangular patches in the peripheral retina. Fundus fluorescein angiography revealed delayed arm to choroidal and retinal circulations in the early phase, with hyperfluorescence and hyperfluorescent staining along the areas of whitening triangular patches in the later phase. Carotid doppler ultrasonography and magnetic resonance angiography confirmed an extracranial left ICAD. After the 3-month follow up, the patient's vision remained NPL with hypo/hyperpigmentation changes along the previous whitish patches in the peripheral retina.
Conclusion And Importance: This case underscores the delayed onset of ocular ischemic symptoms associated with ICAD following head and neck trauma in young individuals. Despite the low risk, patients may need to be informed about the possibility of these late occurring ophthalmic complications and physicians need to stay vigilant for these conditions, which may arise months after the initial trauma.
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http://dx.doi.org/10.1016/j.ajoc.2024.102193 | DOI Listing |
J AAPOS
December 2024
Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address:
Background: There are no clinical parameters that predict response to intra-arterial chemotherapy (IAC), which is a first-line treatment for primary and recurrent unilateral retinoblastoma. We evaluated the utility of ophthalmic ultrasound with color Doppler imaging to predict retinoblastoma response to IAC treatment.
Methods: The medical records of 14 retinoblastoma patients (20 eyes) treated with IAC were reviewed retrospectively.
This study aimed to quantify fundus microvascular alterations in patients requiring revascularization for coronary heart disease (CHD) using swept-source optical coherence tomography angiography (SS-OCTA) and to investigate the correlation between these alterations and the severity of coronary artery lesions. SS-OCTA was employed to assess the fundus neurovascular parameters of all participants, while the Gensini score was utilized to gauge the severity of coronary artery lesions in observation group. A total of 98 participants (49 CHD patients and 49 controls) were included.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
November 2024
Programa de Pós-graduação, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.
Visual deficit after spinal surgery is rare but tragic. The main causes include external eye injury, cortical blindness, central retinal artery occlusion, and ischemic optic neuropathy. In scoliosis surgery, this complication potentially arises from prolonged surgical time, high blood loss, prone position, hydroelectrolytic imbalance, and cerebrospinal fluid loss.
View Article and Find Full Text PDFA 72-year-old male with a history of excessive alcohol intake (35+ units of alcohol daily) presented to the emergency department with bilateral vision loss, periorbital swelling, headache, and sinus congestion with bloody nasal discharge. He was newly diagnosed with diabetes mellitus and presented with severe diabetic ketoacidosis and a hypertensive emergency (blood pressure of 240/90 mmHg). Despite initial normal brain and orbital imaging, the clinical presentation was complicated by multiple life-threatening conditions and a prior immunocompetent status, thereby delaying the early suspicion of mucormycosis.
View Article and Find Full Text PDFCureus
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Neurology, King's College Hospital, Dubai, ARE.
Susac's syndrome is a rare inflammatory microangiopathy characterized by the triad of retinopathy, encephalopathy, and hearing loss. The syndrome causes recurrent microinfarcts in these organs, which in turn manifests with repeated attacks of visual field loss, hearing loss and tinnitus, and various brain syndromes. These often lead to the significant accumulation of disability over time, particularly if there is a delay or failure in diagnosis.
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