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https://www.readbyqxmd.com/read/28644261/is-intravenous-thrombolysis-safe-and-effective-in-central-retinal-artery-occlusion-a-critically-appraised-topic
#1
Oana M Dumitrascu, Joanne F Shen, Madhavi Kurli, Maria I Aguilar, Lisa A Marks, Bart M Demaerschalk, Dean M Wingerchuk, Cumara B O'Carroll
BACKGROUND: Central retinal artery occlusion (CRAO) is a neurological and ophthalmologic emergency associated with poor visual recovery. There is a dilemma regarding the appropriate treatment, as formal guidelines are lacking. Despite being considered an ocular equivalent of cerebral infarction, the time window of intravenous (IV) thrombolysis administration for maximum efficacy and safety in CRAO remains uncertain. OBJECTIVE: To critically assess the current evidence regarding the safety and effectiveness of IV thrombolysis in the treatment of patients with CRAO...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28580223/carotid-cavernous-fistula-with-central-retinal-artery-occlusion-and-terson-syndrome-after-mid-facial-trauma
#2
Satya Karna, Mukesh Jain, Md Shahid Alam, Bipasha Mukherjee, Rajiv Raman
Objectives: To report a rare occurrence combination of central retinal artery occlusion (CRAO) and Terson syndrome in a Barrow's type A carotid cavernous fistula (CCF) patient. Methods: Observational case report. Results: A twenty-year-old male patient with a history of road traffic accident presented with periorbital swelling and redness in the left eye. Examination revealed a CRAO with intraretinal and preretinal hemorrhages. On imaging, type A CCF and subarachnoid hemorrhage were detected. He underwent embolization of the fistula for cosmetic blemish...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28547004/ocular-arterial-occlusive-disorders-and-carotid-artery-disease
#3
Sohan Singh Hayreh, M Bridget Zimmerman
OBJECTIVE: To compare prevalence of carotid artery disease and its various types of lesions in different types of ocular arterial occlusive disorders. DESIGN: Cohort study. SUBJECTS: 614 consecutive patients (728 eyes) with ocular arterial occlusive disorders. METHODS: At first visit, all patients had a detailed ophthalmic and medical history, comprehensive ophthalmic evaluation, and carotid artery evaluation (by Doppler/angiography) on the side of ocular arterial occlusion, and echocardiography...
January 2017: Ophthalmology retina
https://www.readbyqxmd.com/read/28527170/oculo-otological-manifestations-in-a-case-of-granulomatosis-with-polyangiitis
#4
Archana Sonawale, Anjali Rajadhyaksha, Shreepriya Mangalgi
A 44 year old lady presented with acute onset of loss of vision in the right eye and cough with mucopurulent expectoration for two months. Ophthalmic examination revealed central retinal artery occlusion (CRAO). Chest radiograph showed multiple cavitatory nodules with fluid levels. Sputum was negative for AFB and ANCA was strongly positive suggestive of a diagnosis of Granulomatosis with Polyangiitis (GPA). Within the next few weeks the patient had rapid detenoration due to left eye CRAO, progressive bilateral hearing loss, facial palsy and retro orbital mass...
April 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28500127/the-efficacy-of-hyperbaric-oxygen-therapy-in-the-treatment-of-central-retinal-artery-occlusion
#5
Andreia Soares, Nuno L Gomes, Luís Mendonça, Carla Ferreira
Central retinal artery occlusion (CRAO) is an ophthalmological emergency. Various treatment modalities have been tried, but none have shown to alter natural history of the disease. Hyperoxia can restore retinal oxygenation, and favourable results were obtained with hyperbaric oxygen therapy (HBOT). We report two patients with sudden visual loss due to CRAO treated with HBOT. Case 1: a 61-year-old female, presented with CRAO in her left eye(OS). She was submitted to eight sessions of HBOT(2.4atmosphere absolute (ATA))...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28491481/retinal-artery-occlusion-secondary-to-buerger-s-disease-thromboangiitis-obliterans
#6
Erdem Eris, Mehmet Emin Sucu, Irfan Perente, Zeynep Alkın, Abdullah Ozkaya, Hatice Nur Tarakcioglu
Purpose. To report a case report of one patient suffering from retinal artery occlusion secondary to Buerger's disease, in order to raise awareness to this etiology in the differential diagnosis of retinal artery occlusion. Methods. A retrospective case report of a patient with retinal artery occlusion secondary to Buerger's disease. Data retrieved from the medical records included exposure, complaints, visual acuity, clinical findings and imaging, laboratory assessment, treatment, disease course, and visual outcome...
2017: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/28469483/correlation-between-ischemic-retinal-accidents-and-radial-peripapillary-capillaries-in-the-optic-nerve-using-optical-coherence-tomographic-angiography-observations-in-6-patients
#7
Marta Cerdà-Ibáñez, Antonio Duch-Samper, Rodrigo Clemente-Tomás, Raúl Torrecillas-Picazo, Noemí Ruiz Del Río, Laura Manfreda-Dominguez
BACKGROUND: Perfusion of the optic nerve has been widely studied using fluorescein angiography (FAG), which is currently regarded as the criterion standard. However, FAG has adverse effects associated with intravenous contrast administration and is limited in its capacity to characterize and stratify the different vascular layers of the optic nerve and retina. The use of new imaging techniques, such as optical coherence tomographic angiography (Angio-OCT), is therefore important. AIM: A qualitative description is made of the vascular layers of the optic nerve and of how vascular events affect radial peripapillary capillaries (RPC)...
2017: Ophthalmology and Eye Diseases
https://www.readbyqxmd.com/read/28433204/-post-operative-visual-loss-after-cervical-laminectomy-in-prone-position
#8
Kumar Naren Chandra, Meghraj Kundan
Postoperative visual loss is a rare and devastating complication. The estimated incidence is 0.01-1% after non ocular surgery. It has been reported after spine, cardiac and head and neck surgeries. We report a patient who was operated for cervical laminectomy in prone position and complained of loss of vision in one eye postoperatively. He was thoroughly investigated after visual loss. The case was diagnosed as central retinal artery occlusion (CRAO) of the left eye. Here we consider the potential etiological factors causing this unilateral loss of vision and try to suggest strategies to reduce the incidence of the complication in spinal surgery...
April 19, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28340867/comparative-prevalence-of-co-morbidities-in-smoking-and-non-smoking-asthma-patients-with-incomplete-reversibility-of-airway-obstruction-non-smoking-asthma-patients-with-complete-reversibility-of-airway-obstruction-and-copd-patients
#9
Myriam Nadeau, Marie-Ève Boulay, Joanne Milot, Johane Lepage, Lara Bilodeau, François Maltais, Louis-Philippe Boulet
BACKGROUND: Asthma with incomplete reversibility of airway obstruction (IRAO) may often be associated to smoking-induced changes. Nevertheless, a high proportion of patients showing IRAO have never smoked. These patients with IRAO often share features of patients with chronic obstructive pulmonary disease (COPD). Although IRAO is still a poorly defined condition, it has been associated with a higher morbidity and mortality than asthma with complete reversibility of airway obstruction (CRAO) or even COPD alone...
April 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28298862/polycythemia-causing-posterior-segment-vascular-occlusions
#10
Suganeswari Ganesan, Rajiv Raman, Tarun Sharma
A 44-year-old male patient presented with features suggestive of transient central retinal artery occlusion (CRAO) followed by permanent CRAO and lateral posterior ciliary artery occlusion. He had diagnostic features of polycythemia vera (PV). When presented for the first time, the patient had features of ocular ischemia such as ocular pain, conjunctival congestion, and retinal opacification but with normal arm-to-retina time and normal arteriovenous transit time. During the second presentation, he had ocular pain, congested conjunctiva, retinal opacification, cherry red spot with box-carrying of retinal vessels, and choroidal infarct (Amalric's sign)...
January 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28096655/reversibility-of-retinal-ischemia-due-to-central-retinal-artery-occlusion-by-hyperbaric-oxygen
#11
Amir Hadanny, Amit Maliar, Gregory Fishlev, Yair Bechor, Jacob Bergan, Mony Friedman, Isaac Avni, Shai Efrati
PURPOSE: Ischemic retinal damage can be reversed by hyperbaric oxygen therapy (HBOT) as long as irreversible infarction damage has not developed. However, the time window till irreversible damage develops is still unknown. The study aim was to evaluate the effect of HBOT and determine possible markers for irreversible retinal damage. MATERIALS AND METHODS: Retrospective analysis of 225 patients treated with HBOT for central retinal artery occlusion (CRAO) in 1999-2015...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28093631/-retinal-artery-occlusion
#12
N Feltgen, A Pielen
Retinal artery occlusion leads to profound visual impairment in the affected eye. It is rarely caused by local ophthalmic pathologies. Most patients present with a large number of cardio- and cerebrovascular risk factors. Visual loss is the leading symptom in central retinal artery occlusion (CRAO), whereas a circumscribed visual field defect is claimed in branch retinal artery occlusion (BRAO). Although many attempts have been made to improve the course of the disease, no effective therapy is available. There is some hope that intravenous fibrinolysis could influence the natural course but the therapeutic window is small (ca...
February 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28064304/evaluation-of-ophthalmic-artery-branch-retrograde-intervention-in-the-treatment-of-central-retinal-artery-occlusion-crao
#13
RANDOMIZED CONTROLLED TRIAL
Runsheng Wang, Lu Qian, Yi Wang, Yi Zheng, Shanshuang Du, Tao Lei, Peilin Lv, Tan Long, Wenjun Wang
BACKGROUND Central retinal artery occlusion (CRAO) is the occlusion of the central retinal artery resulting in retinal infarction and acute vision loss. Digital subtraction angiography (DSA)-guided superselective ophthalmic artery or selective carotid thrombolysis remains the preferred treatment method for CRAO. This study aimed to evaluate the safety and clinical efficacy of the novel ophthalmic artery branch retrograde thrombolytic intervention for CRAO. MATERIAL AND METHODS Fifty patients with monocular CRAO were enrolled, including 28 males and 22 females (mean age: 55...
January 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27988065/cilioretinal-obstruction-during-pregnancy
#14
J Vila-Arteaga, M M Suriano, A Martínez-Lajara
PURPOSE: To determine the number of patients diagnosed over a 5-year period with isolated occlusion of the cilioretinal artery (CRAO) whilst pregnant, as well as to describe the outcomes and ophthalmological sequelae of this condition in pregnant woman. METHODS: A retrospective study of the medical records. RESULTS: From the 135 patients diagnosed with retinal arterial occlusion of all of our series, 20 (14.8%) had CRAO, and 2 (1.48%) of these were pregnant...
December 14, 2016: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/27941401/new-standards-of-care-in-ischemic-stroke
#15
Bree K Chancellor, Koto Ishida
BACKGROUND: Ischemic arterial strokes of the ophthalmic artery and its branches and posterior cerebral artery are common causes of visual disability. Etiologies of stroke affecting the retina, optic nerve, optic radiation, and visual cortex overlap with other types of ischemic strokes. Stenosis of the internal carotid is the most common cause of central retinal artery occlusion (CRAO). One-fourth of patients with CRAO have cerebral strokes. We report recent developments in the acute treatment and secondary prevention of ischemic stroke of relevance to clinicians who encounter patients with acute vision loss...
December 8, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27938350/central-retinal-artery-occlusion-and-cerebral-infarction-associated-with-mycoplasma-pneumonia-infection-in-children
#16
Yunguang Bao, Xiaobing Li, Kaixuan Wang, Chan Zhao, Xiumei Ji, Mizu Jiang
BACKGROUND: Central retinal artery occlusion (CRAO) is an arterial ischemic stroke, rarely occurred in children accompanied with asymptomatic cerebral infarction and almost never involved in severe pneumonia related to Mycoplasma pneumonia infection. CASE PRESENTATION: An 8-year-old boy with severe pneumonia related to Mycoplasma pneumonia infection that developed loss of vision in the left eye on the 14(th) day. No light perception and no pupillary reaction to light were found in the left eye...
December 9, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27886897/update-on-the-management-of-central-retinal-artery-occlusion
#17
REVIEW
Michael Dattilo, Valérie Biousse, Nancy J Newman
Central retinal artery occlusion (CRAO) is caused by partial or complete occlusion of the central retinal artery, most commonly by an embolus from the ipsilateral carotid artery, aortic arch, or heart, and is the ocular equivalent of an acute cerebral ischemic event. The risk factors for a CRAO and acute cerebral ischemia are very similar, if not identical. Because no current therapeutic intervention has been shown to improve visual outcomes compared with the natural history of CRAO, management of CRAO should be focused on secondary prevention of vascular events, such as cerebral ischemia, myocardial infarction, and cardiovascular death...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27865695/fusiform-left-carotid-ophthalmic-artery-aneurysm-presenting-with-central-retinal-artery-occlusion
#18
Rima M Dafer, John H Pula, Shakeel Chowdhry
Central retinal artery occlusion (CRAO) is a devastating ocular emergency characterized by acute painless visual loss in the ipsilateral eye. We describe the case of acute non-arteritic CRAO associated fusiform internal carotid-ophthalmic artery aneurysm with intraluminal thrombus. Despite the rarity of this condition, we suggest that carotid-ophthalmic artery aneurysm should be included in the differential diagnosis of CRAO.
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27781041/visual-improvement-after-intra-arterial-thrombolysis-for-central-retinal-artery-occlusion-does-not-correlate-with-time-to-treatment
#19
Paul S Page, Alexander C Cambon, Robert F James
BACKGROUND: Intra-arterial thrombolysis (IAT) for the treatment of acute central retinal artery occlusion (CRAO) has demonstrated variable results for improving visual acuity and remains controversial. Despite limited evidence, time from symptom onset to thrombolysis is believed to be an important factor in predicting visual improvement after IAT. METHODS: A comprehensive review of the literature was conducted and individual subject level data were extracted from relevant studies...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27745901/ambient-air-pollution-and-the-risk-of-central-retinal-artery-occlusion
#20
Hui-Chen Cheng, Ren-Hao Pan, Huan-Jui Yeh, K Robert Lai, May-Yung Yen, Chien-Lung Chan, An-Guor Wang
PURPOSE: To investigate whether daily changes in ambient air pollution were associated with an increased risk of central retinal artery occlusion (CRAO). DESIGN: Retrospective population-based cohort study. PARTICIPANTS: We identified patients newly diagnosed with CRAO between 2001 and 2013 in a representative database of 1 000 000 patients that were randomly selected from all registered beneficiaries of the National Health Insurance program in Taiwan...
October 13, 2016: Ophthalmology
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