Spontaneous ophthalmic artery occlusion in children due to Hyperhomocysteinemia

Sachdeva, Virender; Garg, Ravi; Pathengay, Avinash; Kekunnaya, Ramesh

doi:10.4103/0974-620x.159270

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Attenuation of only retinal arterioles has been reported following BRAO [33], CRAO [34], and central retinal vein occlusion (CRVO) [35]; whereas combined arteriolar/venular attenuation has been noted following ophthalmic artery occlusion [36] and BRVO [37].…”

Section: A Note Regarding Retinal Vascular Attenuationmentioning

confidence: 99%

Recognizing Uncommon White Retinal Vasculopathy

Varner¹

2020

Act Sci Oph

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Unusual medical presentations present diagnostic challenges, and correct identification of such conditions represents advanced clinical proficiency. White retinal vessels fall into the category of uncommon ophthalmic findings. This paper reviews presentations of white retinal vasculopathy, the pathophysiology behind those conditions, and the limitations of current terminology. Introduction Health care providers move through a series of steps culminating in the passage of board examinations certifying a basic level of "competency". To achieve this end, initial passive didactic education is integrated with active clinical training and eventually supplanted by immersive patient care. Ultimately, licensure leads to independent practice, yet provider development does not stop there, and the learning curve of clinical knowledge continues, albeit on a flattened trajectory, throughout a career. The medical literature is silent on this accumulation of clinical expertise; however, this author estimates that an additional 5-10 years of experience are required after leaving a training program to master the subtle nuances of patient care, to achieve a thorough proficiency required to evaluate the preponderance of cases in a particular practice on any given day, and to gain an appreciation of the anatomical and physiological changes associated with long-term clinical follow-up care. Because of the extreme variability in pathological manifestations of biological systems, not every single disease entity can be taught to-or even partially absorbed by-students in any training program. Medical trainees are instructed in the recognition of the most common diseases and then-it is hoped-provided a framework for application of certain basic medical principles (case history, physical exam, medical decision-making) to unknown patient presentations. Eventually, clinical intuition develops with accumulated experience. There is no systematic path to advanced clinical knowledge. After structured clinical education is completed, providers are expected to research cases with findings new to them and to consult with colleagues to continue their clinical education-and most do. However, this process continues to be piecemeal-largely dependent upon the caseload of the provider-and the results are haphazard and inconsistent. This gradual attainment of medical knowledge over many years culminates in the attainment of advanced clinical experience but is not attained via a measurable endpoint.

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Section: A Note Regarding Retinal Vascular Attenuationmentioning

confidence: 99%

Recognizing Uncommon White Retinal Vasculopathy

Varner¹

2020

Act Sci Oph

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“…Развитие окклюзии ЦАС в молодом возрасте может быть связано с гипергомоцистеинемией [84] и с повышенным значением ET-1в плазме крови, что характерно для лиц, страдающих первичной сосудистой дисрегуляцией и эндотелиальной дисфункцией [33].…”

Section: эндотелиальная дисфункция и окклюзия ветвиunclassified

The role of endothelium dysfunction in the pathogenesis of vascular ocular diseases

Астахов

Тульцева

Titarenko

2016

Regional blood circulation and microcirculation

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Vascular endothelium plays the key role in the control of vascular tone due to release of vasoactive substances. Reduction of retinal, choroidal and optic nerve head blood flow is above all a result of misbalance between endothelium-produced vasoconstrictors and vasodilators mainly ET-1 and NO. NO is involved in the maintenance of choroidal, optic nerve head and retinal basal blood flow. Combination of NO deficiency and overproduction of ET-1 is accompanied by diabetic retinopathy, glaucomatous optic nerve atrophy, retinal vascular occlusion and other ocular disease. In the review, the role of endothelium dysfunction in the pathogenesis of vascular ocular diseases and the advisability of drugs inclusion for correction of endothelium dysfunction in the medical therapies complex are discussed.

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“…OAO is rare, comprising 2% of all ocular vascular occlusions and most commonly affects middle age to elderly patients with cardiovascular disease (1). Cases of OAO in the pediatric population have been reported, most due to prolonged surgery, periocular injections, embolic phenomena, and hyperhomocysteinemia (2). To the authors knowledge, there has not been a reported case in the setting of FCA.…”

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confidence: 99%

“…The better than anticipated vision was possibly due to a patent cilioretinal artery system, which is present in approximately 36% of the general population (3). Although the presence of a cherry red spot is characteristic of CRAO, it can be present in OAO if the choroidal circulation recovers, even partially (2). Partial choroidal recovery may also have contributed to our patient’s relatively good vision.…”

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confidence: 99%