Severe acute ocular ischemia associated with spontaneous internal carotid artery dissection

Abstract

A healthy 40-year-old man developed unilateral ocular ischemic syndrome as the only manifestation of a spontaneous internal carotid artery dissection.

Ocular ischemic syndrome: recent trends in medical management

“…It has been suggested that the hemorrhages seen in OIS are secondary to microaneurysms and neovascularization [5]. The new vessels that arise via neovascularization and microaneurysms tend to be increasingly friable and prone to hemorrhage [7]. Fluorescein angiography in affected eyes of patients with OIS commonly reveals delayed retinal and choroidal filling [7].…”

“…The new vessels that arise via neovascularization and microaneurysms tend to be increasingly friable and prone to hemorrhage [7]. Fluorescein angiography in affected eyes of patients with OIS commonly reveals delayed retinal and choroidal filling [7]. Ophthalmodynamometry may reveal decreased central retinal artery perfusion pressure and electroretinography may demonstrate decreased amplitude of both 'a' and 'b' waves [7].…”

“…OIS most commonly afflicts the elderly with a mean age of approximately 64 years [7]. OIS has a predilection for men in whom the disorder occurs twice as commonly as in women [7].…”

“…Notwithstanding, this condition is highly underdiagnosed. Given the association with serious systemic diseases, failure to promptly recognize and appropriately treat OIS can result in serious consequences for those afflicted with the disease [5][6][7][8].…”

“…Carotid artery dissection has also been reported as a cause of mortality in OIS patients [1,6]. Ocular sequelae in patients with OIS, although not lifethreatening, represent important sources of morbidity and may cause severe vision loss [2,5,7].…”