PURPOSE: We report a case of amaurosis fugax associated with ipsilateral internal carotid artery agenesis. CASE SUMMARY: A 50-year-old woman presented with amaurosis fugax in her left eye; the frequency of episodes of the condition had recently increased to once a month. She had a history of hypertension and dyslipidemia, and was under medical therapy. The visual acuity of both eyes was 20/20. Slit-lamp examination was normal except for pseudophakia. Ophthalmoscopy revealed a myopic tigroid fundus and a myopic tilted disc. No abnormalities were evident in fluorescein fundus angiography. Brain computed tomography showed that the left bony carotid canal was absent, and magnetic resonance angiography showed that the left internal carotid artery was also absent. She was diagnosed with left internal carotid artery agenesis. Other neurological and hematological parameters were within normal ranges. The amaurosis fugax spontaneously disappeared and has not recurred over the past 12 months. Our case, although rare, suggests that amaurosis fugax may be associated with internal carotid artery agenesis.
Amaurosis Fugax* ; Angiography ; Blindness* ; Brain ; Carotid Artery, Internal* ; Dyslipidemias ; Female ; Fluorescein ; Humans ; Hypertension ; Magnetic Resonance Angiography ; Middle Aged ; Ophthalmoscopy ; Pseudophakia ; Reference Values ; Visual Acuity

No abstract available.
Amaurosis Fugax* ; Retinaldehyde*

No abstract available.
Amaurosis Fugax* ; Retinaldehyde*

PURPOSE: To investigate the prevalence of ocular and systemic disease causing amaurosis fugax and to discuss the ocular and systemic manifestation of each disease. METHODS: Consecutive patients who had amaurosis fugax were retrospectively studied from 2007 to 2013. Carotid evaluation using Doppler was performed in all patients. Ocular and medical histories were taken and bilateral ophthalmic evaluation performed. RESULTS: This study included 35 patients. The mean age of patients was 63 years and 27 patients were male; 29 unilateral and 6 bilateral eyes were involved. Associated systemic disease included hypertension (54.3%) and diabetes mellitus (34.2%). The most frequent cause of amaurosis fugax was retinal artery occlusion (28.6%) followed by ocular ischemic syndrome (22.9%), other vascular diseases (11.4%), and retinal vein occlusion (5.7%). The remaining 31.4% patients with amaurosis fugax had no vascular disease. Clinically significant stenosis of the internal carotid artery was observed in 16 patients (45.7%) and 6 of these patients (37.5%) had retinal artery occlusion disease. CONCLUSIONS: Prevalence and clinical manifestation of amaurosis fugax is very complex. Patients with transient visual disturbance are at risk for retinal artery occlusion, ocular ischemic syndrome and other diseases which cause visual loss. Therefore, careful history taking and urgent systemic and ophthalmic evaluations should be performed.
Amaurosis Fugax* ; Carotid Artery, Internal ; Carotid Stenosis ; Constriction, Pathologic ; Diabetes Mellitus ; Humans ; Hypertension ; Male ; Observational Study* ; Prevalence ; Retinal Artery Occlusion ; Retinal Vein Occlusion ; Retrospective Studies ; Vascular Diseases

Amaurosis Fugax ; etiology ; therapy ; Anesthetics, Local ; adverse effects ; Anxiety ; complications ; Humans ; Injections, Intraocular ; adverse effects ; Orbit ; blood supply ; drug effects

No abstract available.
Amaurosis Fugax ; Antineoplastic Combined Chemotherapy Protocols ; Blindness ; Cyclophosphamide ; Doxorubicin ; Neurilemmoma ; Podophyllotoxin ; Vincristine

PURPOSE: To report the case of a patient with transient visual loss with a peripapillary staphyloma. CASE SUMMARY: The authors of the present study examined a 30-year-old woman who complained of transient visual loss in her right eye. The patient lost her vision for 5 seconds on average approximately 5 times a day. Her visual acuity was 20/20 in both eyes. There were no abnormalities on slit lamp examination. A deep excavation with choroidal atrophy in the peripapillary area of the right eye was found. The patient was diagnosed with peripapillary staphyloma. Her physiological blind spot in the right eye was enlarged on Humphrey visual field testing. However, she had no abnormalities on color vision testing, fluorescein angiography, or magnetic resonance imaging (MRI). There were no abnormalities in the evaluation of the brain, carotid arteries, or heart. There was no evidence of vasculitis or hypercoagulability. The symptom did not change on pressing the eyeball, performing the Valsalva maneuver or carotid massage, applying cycloplegics, or shining a strong light in the other eye. The symptom did not change after taking a calcium channel blocker for 4 weeks.
Adult ; Amaurosis Fugax ; Atrophy ; Brain ; Calcium Channels ; Carotid Arteries ; Choroid ; Color Vision ; Eye ; Female ; Fluorescein Angiography ; Heart ; Humans ; Light ; Magnetic Resonance Imaging ; Massage ; Mydriatics ; Optic Disk ; Thrombophilia ; Valsalva Maneuver ; Vasculitis ; Vision, Ocular ; Visual Acuity ; Visual Field Tests

PURPOSE: To report the case of a patient with amaurosis fugax that occurred following a Valsalva maneuver. CASE SUMMARY: A 40-year-old man presented with amaurosis fugax of the right eye, which had occurred several times during the previous month. After coughing, the visual acuity of the right eye decreased temporarily during the first episode. Subsequently, any time a Valsalva maneuver, such as coughing, occurred, this symptom reappeared. Initially, this symptom persisted for five to ten minutes and occurred once or twice a day, but it gradually increased in frequency. The physical examination was normal, and his best corrected visual acuity was 20/20 bilaterally. Neither specific findings in the slit lamp examination nor abnormal findings in the fundus examination were detected. On fluorescein fundus angiography, no abnormal finding was observed before the symptom was triggered by a Valsalva maneuver, but after the symptom was triggered by coughing, the choroidal and retinal arterial phases were delayed. Hematological and neurological examinations, including magnetic resonance imaging, magnetic resonance angiography, and cerebral angiography, were all normal. Therefore, he was diagnosed with amaurosis fugax generated by a Valsalva maneuver. CONCLUSIONS: In any patient who complains of amaurosis fugax repeatedly, as seen in this case, one must consider the possibility that it results from a Valsalva maneuver, after eliminating occlusive vascular diseases, such as carotid stenosis or atherosclerotic disease.
Adult ; Amaurosis Fugax ; Angiography ; Blindness ; Carotid Stenosis ; Cerebral Angiography ; Choroid ; Cough ; Eye ; Fluorescein ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Neurologic Examination ; Physical Examination ; Retinaldehyde ; Valsalva Maneuver ; Vascular Diseases ; Visual Acuity

PURPOSE: To report a case of ocular ischemic syndrome successfully treated with delayed carotid angioplasty and stenting (CAS). CASE SUMMARY: A 52-year-old male was admitted to our hospital because of amaurosis fugax-like symptoms in the right eye for several months. His visual acuity was 0.8 in the right eye and he did not have rubeosis iridis. Neovascularization of the disc, narrowing of the retinal artery and multiple retinal hemorrhages were diagnosed by fundus examination. Fluorescein angiography showed delayed choroidal filling, a delayed arm-to-retina time, prolongation of arteriovenous transit time, neovascularization of the disc, retinal capillary nonperfusion, and staining of the retinal vessels. MR angiography showed severe stenosis in the proximal portion of the right carotid artery. We diagnosed this case as ocular ischemic syndrome. The patient was recommended carotid angioplasty and stenting at the severely narrowed portion of the right carotid artery, but it was postponed about six months after diagnosis because of personal problems. At the final follow-up, 24 months after stenting, the amaurosis fugax symptoms had disappeared, the patient had an improved visual acuity of 1.0, and the new vessels on the disc changed to fibrous tissue. Fluorescein angiography showed resolution of the delayed arm-to-retina time and prolongation of the arteriovenous transit time, disappearances of the leakage around the disc and the retinal capillary nonperfusion.
Amaurosis Fugax ; Angiography ; Angioplasty ; Blindness ; Capillaries ; Carotid Arteries ; Choroid ; Constriction, Pathologic ; Eye ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retinal Artery ; Retinal Hemorrhage ; Retinal Vessels ; Retinaldehyde ; Stents ; Visual Acuity

Two patients presented with amaurosis fugax(AMF), despite treatment with antiplatelet drugs and anticoagulants due to previous transient ischemic attacks. Angiography demonstrated severe stenosis in the cavernous and petrous internal carotid artery(ICA) respectively, with reduced flow in the ophthalmic artery(OA). Endovascular stent placement in both patients resulted in normalization of the vessel lumen of the stenotic vessel segments. In addition, complete restoration of OA flow was noted immediately after stenting. Both patients showed no further episode of AMF over a follow-up period of 38 and 23 months respectively. Our clinical and angiographic findings suggest that hemodynamic insufficiency in retinal vasculature caused by a stenosis of the cavernous or petrous ICA can be treated successfully by endovascular stent.
Amaurosis Fugax* ; Angiography ; Anticoagulants ; Blindness* ; Carotid Artery, Internal* ; Constriction, Pathologic* ; Follow-Up Studies ; Hemodynamics ; Humans ; Ischemic Attack, Transient ; Ophthalmic Artery* ; Platelet Aggregation Inhibitors ; Retinaldehyde ; Stents*