Arteries ; Ciliary Arteries ; Prognosis ; Retinal Artery Occlusion ; Retinal Artery ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Visual Fields

BACKGROUND: Retinal artery occlusion can lead to sudden visual loss without pain. The acute management of retinal artery occlusion remains unresolved. CASE REPORT: A 65-year-old male was hospitalized to an emergency room for visual loss on the left side within 6 hours of onset. Combined occlusion at retinal artery and ciliary artery was confirmed by an ophthalmologist and we assessed ophthalmic artery occlusion. However, MRA revealed no significant steno-occlusion of internal carotid artery. Transfemoral cerebral angiography was carried out immediately and showed a movable thrombus at the orifice of the ophthalmic artery. We decided on endovascular thrombectomy to prevent permanent visual loss. Finally, his visual acuity was improved after successful thrombectomy. CONCLUSIONS: Although MRA is intact, small thrombus right at the orifice of the ophthalmic artery can cause a sudden monocular visual loss due to occlusion of the retinal artery. In this setting, urgent endovascular thrombectomy can offer visual improvement.
Aged ; Blindness ; Carotid Artery, Internal ; Cerebral Angiography ; Ciliary Arteries ; Emergency Service, Hospital ; Humans ; Male ; Ophthalmic Artery ; Retinal Artery ; Retinal Artery Occlusion ; Thrombectomy ; Thrombosis ; Visual Acuity

PURPOSE: To assess the usefulness of two spectral domain optical coherence tomography (SD-OCT) instruments (Cirrus(R), Spectralis(R)) for evaluating optic nerve head and peripapillary structures. METHODS: Images of optic nerve complex were obtained from 136 eyes of 136 patients using enhanced depth imaging technique of 2 SD-OCT instruments. Optic nerve head and peripapillary structures were investigated for their visibility and morphological features in total eyes and glaucomatous eyes. Effect factors for laminar thickness measurement were evaluated and the reproducibility of the lamina cribrosa thickness measured by the 2 OCT instruments was analyzed. RESULTS: Lamina cribrosa thickness was better identified using Spectralis(R) OCT in total and glaucomatous eyes. Short posterior ciliary artery (in total eyes) and peripapillary choroid (in total and glaucomatous eyes) were also better identified using Spectralis(R) OCT (p < 0.001). A cup-disc ratio < or = 0.6 was the significant effect factor for laminar thickness measurement (p < 0.05). Interobserver reproducibility was excellent using both OCT instruments. Intraobserver reproducibility was excellent using Spectralis(R) OCT and moderate using Cirrus(R) OCT. CONCLUSIONS: Spectralis(R) OCT was better for visualizing optic nerve head and peripapillary structures and showed better reproducibility than Cirrus(R) OCT. Thus, the Spectralis(R) may be helpful for detecting and understanding features of the optic nerve complex.
Choroid ; Ciliary Arteries ; Glaucoma ; Humans ; Optic Disk ; Optic Nerve* ; Tomography, Optical Coherence*

No abstract available.
Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/*therapeutic use ; Choroid/*blood supply ; Ciliary Arteries/pathology ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Ischemia/*drug therapy/etiology/physiopathology ; Male ; Meningeal Neoplasms/surgery ; Meningioma/surgery ; Neurosurgical Procedures/*adverse effects ; Retinal Detachment/*drug therapy/etiology/physiopathology ; Subretinal Fluid ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Young Adult

PURPOSE: Nonarteritic anterior ischemic optic neuropathy (NAION) is believed to result from inadequate blood supply to the posterior ciliary arteries. To date, NAION in a patient with acute angle-closure glaucoma (AACG) has been reported in only two studies in the English literature. Thus, the authors report a case of NAION following AACG in a Korean patient. CASE SUMMARY: A 59-year-old woman presented with a three-day history of acute ocular pain and decreased vision in her right eye; visual acuity was hand movement and the intraocular pressure (IOP) was 66 mm Hg in the right eye. Slit-lamp examination of the patient's right eye revealed diffuse corneal edema, shallow anterior chamber, and mid-dilated pupil. Gonioscopy revealed a grade 0 angle in the right eye, and a relative afferent pupillary defect was noted. Fundus photography showed disc hemorrhage and swelling of the optic disc. Fluorescein angiography demonstrated hyperfluorescence of the optic disc due to leakage. Visual evoked potential of the right eye at the initial visit showed a decreased amplitude of P100 compared with that of the left eye. A diagnosis of NAION following AACG was made. Laser iridotomy was successfully performed to the right eye. Two months later, IOP decreased from 66 to 21 mm Hg. However, visual acuity remained as hand movement and fundus examination revealed a pale optic disc. CONCLUSIONS: NAION following AACG may be attributed to an acute IOP rise with resultant perfusion pressure decrease in the vessels which supply the optic nerve. The result obtained from the patient in the present study indicates that evaluation for NAION should be considered in AACG cases.
Anterior Chamber ; Ciliary Arteries ; Corneal Edema ; Evoked Potentials, Visual ; Eye ; Female ; Fluorescein Angiography ; Glaucoma, Angle-Closure ; Gonioscopy ; Hand ; Hemorrhage ; Humans ; Intraocular Pressure ; Middle Aged ; Optic Nerve ; Optic Neuropathy, Ischemic ; Patient Rights ; Perfusion ; Photography ; Pupil ; Pupil Disorders ; Vision, Ocular ; Visual Acuity

Color Doppler imaging (CDI) was carried out to evaluate the effects of anti-glaucoma drugs on ophthalmic circulation using CDI-derived resistive index (RI) values. CDI was performed on nine Beagle dogs, and RI values were calculated for the medial long posterior ciliary artery before and after the administration of anti-glaucoma drugs. A significant increase in RI values was found after topical administration of levobunolol (p < 0.05) or dipivefrin (p < 0.05). Pilocarpine showed no effects on RI values after topical administration. The results suggest that some anti-glaucoma drugs could affect ophthalmic blood flow.
Adrenergic Agonists/pharmacology ; Animals ; Ciliary Arteries/*drug effects/*ultra ; Dogs ; Epinephrine/analogs & derivatives/therapeutic use ; Eye/*blood supply ; Female ; Glaucoma/*drug therapy ; Levobunolol/therapeutic use ; Male ; Ocular Physiological Phenomena ; Pilocarpine/therapeutic use ; Ultra ; *Vascular Resistance

PURPOSE: To report an unusual case of anterior ischemic optic neuropathy and choroidal ischemia after injection of autologous fat into the periorbital region due to embolism of the short posterior ciliary artery without involving the retinal artery. CASE SUMMARY: A 39-year-old female presented with sudden blurred vision, diplopia and ptosis of her left eye immediately after receiving an autologous fat injection into the periorbital area. The first ophthalmologic examination revealed that the patient s left eye had decreased visual acuity, relative afferent pupillary defect, exotropia, and hypertropia. Fundus examination of the left eye showed disc edema. Fluorescein angiography showed multiple choroidal vascular filling defects at the early phase and wedge-shaped or geographic fluorescein staining at the superior, inferior, and temporal peripheral areas at late phase. Humphrey visual field test results disclosed an inferior visual field defect. On the follow-up visit after oral steroid therapy (prednisolone 30 mg) for 7 days, diplopia disappeared and visual acuity recovered to 1.0. The inferior visual field defect and relative afferent pupillary defect were still present.
Adult ; Choroid ; Ciliary Arteries ; Diplopia ; Edema ; Embolism ; Exotropia ; Eye ; Female ; Fluorescein ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Ischemia ; Optic Neuropathy, Ischemic ; Pupil Disorders ; Retinal Artery ; Strabismus ; Vision, Ocular ; Visual Acuity ; Visual Field Tests ; Visual Fields

The effect of betaxolol and dipivefrin on microcirculation of peripapil lary reina and optic disc in normal tension glaucoma was assessed. Betaxolol, selective beta-1 blocker, was known to improve the blood flow of retrobulbar arteries, and dipivefrin was known to decrease the flow of ciliary body. Total subjects were 29 normal tension glaucoma patients; 18 subjects with no previous IOP reducing eye drops during 4 weeks were assigned for betaxolol group, and 11 subjects with using timolol for dipivefrin group. The intraocular pressure was significantly reduced after instillation in betaxolol group(p<0.01), and in dipivefrin group(p<0.05). But systemic blood pressure and pulse rate were not changed after instillations in both groups. Blood flow, volume, velocity of optic disc and peripapillary retina of betaxolol group and dipivafrin group were not significantly changed. From the above results, we concluded that betaxolol and dipiverin with timolol did not influenced the microcirculation of peripapillary retina and opit disc.
Arteries ; Betaxolol* ; Blood Pressure ; Ciliary Body ; Heart Rate ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Microcirculation ; Ophthalmic Solutions ; Optic Disk* ; Optic Nerve* ; Retina ; Retinaldehyde* ; Timolol

This study was performed to evaluate the effect of hematoma which often occurred during the strabismus surgery on the extraocular muscles. We created focal hematomas around the superior rectus mascles of three dogs by rupture of the anterior ciliary artery. One, two and four weeks after formation of the hematoma respectively, we resected the superior rectus muscles 7mm in length at the site of previous hematoma and histopathologic examination with a light microscope was performed. We could not find any specific pathologic change in the muscular fiber in one week after surgery. But, focal degeneration of the muscle fiber was found in that of two weeks and diffuse degeneration in that of four weeks after surgery. However, any fibrotic lesion was not found. The muscle degeneration may be caused by the pressure of hematoma and ischemia due to small arterial occlusion.
Animals ; Ciliary Arteries ; Dogs ; Hematoma* ; Ischemia ; Muscles ; Rupture ; Strabismus

To develop a new animal model for ischemia-reperfusion infury of the optic nerve in rabbits and to investigate the pattern of retinal ganglion cell apoptosis and bcl-2 staining in the model, occlusion of the posterior ciliary arteries for 2 hours and reperfusion were performed in one eye of thirty rabbits. In Group I(15 eyes), the optic nerve and the posterior ciliary arteries were tied while in Group II(15 eyes), the posterior ciliary arteries only were tied. The contralateral eyes received sham operation without occlusion. Following reperfusion of 24 hours(5 eyes), 48 hours(5 eyes), and 1 week(5 eyes), in each group respectively, both eyes were enucleated. TUNEL(TdT-mediated dUTP nick end labeling) staining for DNA fragmentation and bcl-2 immunohistochemical staining were done. The numbers of TUNEL-postitive ganglion cells were significantly increased at 24 and 48 hours in Group I and II compared to the control eyes(P<0.05). The numbers of TUNEL-positive ganglion cells in Group I were significantly larger than in Group II at 48 hours(p=0.01). Though the numbers of TUNEL-positive ganglion cells decreased progressively until 1 week, those in Group II at 1 week were still significantly larger than in control eyes(P=0.04), Which suggested the ischemia-reperfusion induced apoptosis of ganglion cell occurred at least until 1 week. Bcl-2 was stained strongly positive at the TUNEL-positive area and in Muller cells compared to the control eyes. The ischemia-reperfusion injury of the optic nerve induced apoptosis of retinal ganglion cell in the new animal model. The overexpressionof bcl-2 at the TUNEL-positive area and in Muller cells can be assumed to be a defense mechanism against retinal ganglion cell death by apoptosis under the ischemic condition. The results of this study will provide baseline data ganglion cell death.
Apoptosis* ; Cell Death ; Ciliary Arteries ; DNA Fragmentation ; Ependymoglial Cells ; Ganglion Cysts ; Models, Animal ; Optic Nerve* ; Rabbits* ; Reperfusion ; Reperfusion Injury* ; Retinal Ganglion Cells* ; Retinaldehyde*