A rare but important differential diagnosis in transient monocular blindness

Mehrzad, Raman; Bajaj, Rishi

doi:10.1136/bcr-2014-206812

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…Although most literature on TVL focuses on carotid artery disease, emboli can originate from atrial fibrillation, valvular disease, and other sources from the heart, including mobile masses. 30 Management of the TVL when by a cardiac cause is also then dependent on the specific cardiac problem. Recognizing that thromboembolic TVL is not always carotid in origin should prompt evaluation with echocardiogram and electrocardiogram.…”

Section: Tvl and Thromboembolic Vascular Diseasementioning

confidence: 99%

Update on the evaluation of transient vision loss

Pula¹,

Kwan²,

Yuen³

et al. 2016

OPTH

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Transient vision loss may indicate underlying vascular disease, including carotid occlusion and thromboembolism, or it may have a more benign etiology, such as migraine or vasospasm. This review focuses on the differential diagnosis and workup of patients presenting with transient vision loss, focusing on several key areas: the relationship to thromboembolic vascular disease, hypercoagulable testing, retinal migraine, and bilateral vision loss. The objective is to provide the ophthalmologist with information on how to best manage these patients. Thromboembolic etiologies for transient vision loss are sometimes managed with medications, but when carotid surgery is indicated, earlier intervention may prevent future stroke. This need for early treatment places the ophthalmologist in the important role of expediting the management process. Hospital admission is recommended in patients presenting with transient symptoms within 72 hours who meet certain high-risk criteria. When the cause is giant cell arteritis, ocular ischemic syndrome, or a cardioembolic source, early management of the underlying condition is equally important. For nonthromboembolic causes of transient vision loss such as retinal migraine or retinal vasospasm, the ophthalmologist can provide reassurance as well as potentially give medications to decrease the frequency of vision loss episodes.

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Section: Tvl and Thromboembolic Vascular Diseasementioning

confidence: 99%

Update on the evaluation of transient vision loss

Pula¹,

Kwan²,

Yuen³

et al. 2016

OPTH

View full text Add to dashboard Cite

show abstract

“…A prospective study revealed that cardiac embolism occurred in 8.7% of patients presenting with AF. Less commonly, cardiac emboli can originate from atrial fibrillation, valvular disease, atrial myxoma, mitral valve prolapse, and other sources within the heart, including mobile masses [ 8 , 9 ]. Cardiac disease, especially myocardial infarction or failure, occurs in 8% of patients presenting with AF [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Associations among Stroke, Myocardial Infarction, and Amaurosis Fugax in a Tertiary Referral Hospital in Taiwan

Sun

Ognoo

2022

JCM

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Background: To determine the associations among carotid stenosis, stroke, and myocardial infarction (MI) in patients with amaurosis fugax (AF). Methods: We retrospectively reviewed the records of patients diagnosed as having AF between January 2000 and December 2019. Among 14,857 patients with AF initially reviewed in the database, only 173 were ultimately enrolled, after excluding patients with wrong diagnosis, insufficient medical records, or loss of follow-up. Results: Of the 173 patients with AF, 61 (35.3%) had carotid stenosis, and among them, 18 (10.4%) had severe stenosis. In multivariate regression analysis, carotid stenosis was significantly associated with age (p = 0.009), male sex (p = 0.006), and ischemic heart disease (p = 0.039). Sixteen (9.2%) patients experienced a stroke after AF diagnosis (mean time to stroke: 23.1 ± 31.1 months, range: 1 day~85 month), 11 (68.8%) of whom had carotid artery stenosis (p = 0.003). Three (1.7%) patients had MI after AF (mean time to MI: 24.8 ± 35.9 months, range: 12 days~66 months), none of whom had carotid artery stenosis (p = 0.553). Four (2.3%) patients had central retinal artery occlusion (CRAO) after AF, all of whom had carotid artery stenosis (p = 0.034). Conclusions: A high incidence of internal carotid artery stenosis was observed after AF attack and was significantly associated with stroke. The incidence of MI and CRAO after AF was low. Among them, only CRAO was associated with carotid artery stenosis.

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A rare but important differential diagnosis in transient monocular blindness

Cited by 2 publications

References 3 publications

Update on the evaluation of transient vision loss

Update on the evaluation of transient vision loss

Associations among Stroke, Myocardial Infarction, and Amaurosis Fugax in a Tertiary Referral Hospital in Taiwan

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