Central Retinal Artery Occlusion Associated with Carotid Artery Occlusion

Weymouth, Wells; Pedersen, Craig A.

doi:10.5811/cpcem.2019.4.40847

Cited by 9 publications

(11 citation statements)

References 28 publications

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“…For systemic issues, it is unclear whether these would have been correctly identified in a F2F appointment. The most likely cause of a sudden ‘painless loss of vision’ in a patient aged over 30 is a central retinal artery occlusion which, if undetected, could be life threatening 36,37 . The number of potentially missed systemic conditions ( n = 8) that could have been life threatening might indicate deficiencies in the training of UK optometrists.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service across five areas in England

Swystun

Davey

2021

Ophthalmic Physiologic Optic

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Purpose Although urgent primary eye care schemes exist in some areas of England, their current safety is unknown. Accordingly, the aim of the present study was to quantify the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service (CUES) across Luton, Bedford, Hull, East Riding of Yorkshire and Harrogate. Methods Consenting patients with acute onset eye problems who had accessed the service were contacted to ascertain what the optometrist's recommendation was, whether this worked, if they had to present elsewhere and how satisfied they were with the CUES. Results A total of 27% (170/629) and 6.3% (28/445) of patients managed virtually and in person, respectively, did not have their acute eye problem resolved. Regression analysis revealed that patients who attended a face‐to‐face consultation were 4.66 times more likely to be correctly managed [Exp (β) = 5.66], relative to those solely managed virtually. Optometrists' phone consultations failed to detect conditions such as stroke, intracranial hypertension, suspected space occupying lesions, orbital cellulitis, scleritis, corneal ulcer, wet macular degeneration, uveitis with macular oedema and retinal detachment. Of referrals to hospital ophthalmology departments, in total, 19% were false‐positives. Patients, however, were typically very satisfied with the service. Uptake was associated with socioeconomic status. Conclusion The present study found that a virtual assessment service providing optometrist tele‐consultations was not effective at resolving patients' acute‐onset eye problems. The range and number of pathologies missed by tele‐consultations suggests that the service model in the present study was detrimental to patient safety. To improve this, optometrists should follow evidence based guidance when attempting to manage patients virtually, or in person. For example, patients presenting with acute‐onset symptoms of flashing lights and/or floaters require an urgent dilated fundus examination. Robust data collection on service safety is required on an ongoing basis.

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Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service across five areas in England

Swystun

Davey

2021

Ophthalmic Physiologic Optic

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“…Anatomically, the central retinal artery is derived from the ophthalmic artery, one of the branches of the internal carotid artery of the common carotid artery. Therefore, carotid artery occlusion could potentially induce CRAO, finally leading to ocular ischemia and vision loss [ 15 , 16 ]. Bilateral common carotid artery occlusion to induce ocular ischemia has been applied to rats, in that the circle of Willis in rats is well-organized [ 9 , 10 , 11 , 12 , 13 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Fenofibrate Protects against Retinal Dysfunction in a Murine Model of Common Carotid Artery Occlusion-Induced Ocular Ischemia

et al. 2021

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Ocular ischemia is a common cause of blindness and plays a detrimental role in various diseases such as diabetic retinopathy, occlusion of central retinal arteries, and ocular ischemic syndrome. Abnormalities of neuronal activities in the eye occur under ocular ischemic conditions. Therefore, protecting their activities may prevent vision loss. Previously, peroxisome proliferator-activated receptor alpha (PPARα) agonists were suggested as promising drugs in ocular ischemia. However, the potential therapeutic roles of PPARα agonists in ocular ischemia are still unknown. Thus, we attempted to unravel systemic and ocular changes by treatment of fenofibrate, a well-known PPARα agonist, in a new murine model of ocular ischemia. Adult mice were orally administered fenofibrate (60 mg/kg) for 4 days once a day, followed by induction of ocular ischemia by unilateral common carotid artery occlusion (UCCAO). After UCCAO, fenofibrate was continuously supplied to mice once every 2 days during the experiment period. Electroretinography was performed to measure retinal functional changes. Furthermore, samples from the retina, liver, and blood were subjected to qPCR, Western blot, or ELISA analysis. We found that fenofibrate boosted liver function, increased serum levels of fibroblast growth factor 21 (FGF21), one of the neuroprotective molecules in the central nervous system, and protected against UCCAO-induced retinal dysfunction. Our current data suggest a promising fenofibrate therapy in ischemic retinopathies.

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“…2021, 22, 9408 2 of 21 from the ophthalmic artery, one of the internal carotid artery's branches of the common carotid artery. In this regard, occlusion of the carotid artery can cause retinal ischemia leading to vision loss [19,20]. There have been several ways of developing murine models of carotid artery occlusion depending on the species.…”

Section: Introductionmentioning

confidence: 99%

Pemafibrate Prevents Retinal Dysfunction in a Mouse Model of Unilateral Common Carotid Artery Occlusion

Lee

Tomita

Jeong

et al. 2021

IJMS

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Cardiovascular diseases lead to retinal ischemia, one of the leading causes of blindness. Retinal ischemia triggers pathological retinal glial responses and functional deficits. Therefore, maintaining retinal neuronal activities and modulating pathological gliosis may prevent loss of vision. Previously, pemafibrate, a selective peroxisome proliferator-activated receptor alpha modulator, was nominated as a promising drug in retinal ischemia. However, a protective role of pemafibrate remains untouched in cardiovascular diseases-mediated retinal ischemia. Therefore, we aimed to unravel systemic and retinal alterations by treating pemafibrate in a new murine model of retinal ischemia caused by cardiovascular diseases. Adult C57BL/6 mice were orally administered pemafibrate (0.5 mg/kg) for 4 days, followed by unilateral common carotid artery occlusion (UCCAO). After UCCAO, pemafibrate was continuously supplied to mice until the end of experiments. Retinal function (a-and b-waves and the oscillatory potentials) was measured using electroretinography on day 5 and 12 after UCCAO. Moreover, the retina, liver, and serum were subjected to qPCR, immunohistochemistry, or ELISA analysis. We found that pemafibrate enhanced liver function, elevated serum levels of fibroblast growth factor 21 (FGF21), one of the neuroprotective molecules in the eye, and protected against UCCAO-induced retinal dysfunction, observed with modulation of retinal gliosis and preservation of oscillatory potentials. Our current data suggest a promising pemafibrate therapy for the suppression of retinal dysfunction in cardiovascular diseases.

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Central Retinal Artery Occlusion Associated with Carotid Artery Occlusion

Cited by 9 publications

References 28 publications

A prospective evaluation of the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service across five areas in England

A prospective evaluation of the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service across five areas in England

Fenofibrate Protects against Retinal Dysfunction in a Murine Model of Common Carotid Artery Occlusion-Induced Ocular Ischemia

Pemafibrate Prevents Retinal Dysfunction in a Mouse Model of Unilateral Common Carotid Artery Occlusion

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