Urticaria in idiopathic bilateral recurrent branch retinal arterial occlusion

Barak, Nir; Ferencz, J. R.; Freund, Michael R.; Mekori, Yoseph A.

doi:10.1111/j.1600-0420.1997.tb00264.x

Cited by 7 publications

(9 citation statements)

References 6 publications

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“…This has been reported by several authors as distinct clinical entity (Barak et al , 1997; Beiran et al , 1995; Beversdorf et al , 1997; Johnson et al , 1994), and I have seen such patients. Most of these patients probably have Susac’s syndrome or recurrent embolization from lesions in the carotid arteries or the heart.…”

Section: Branch Retinal Arteriolar Occlusionsupporting

confidence: 68%

Acute retinal arterial occlusive disorders

Hayreh

2011

Progress in Retinal and Eye Research

320

309

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The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual acuity improvement during the first 7 days differs significantly (p<0.001) among the 4 types of CRAO; among them, in eyes with initial visual acuity of counting finger or worse, visual acuity improved, remained stable or deteriorated in nonarteritic CRAO in 22%, 66% and 12% respectively; in nonarteritic CRAO with cilioretinal artery sparing in 67%, 33% and none respectively; and in transient nonarteritic CRAO in 82%, 18% and none respectively. Arteritic CRAO shows no change. Recent studies have shown that administration of local intra-arterial thrombolytic agent not only has no beneficial effect but also can be harmful. Prevalent multiple misconceptions on CRAO are discussed. Branch retinal artery occlusion Pathogeneses, clinical features and management of various types of BRAO are discussed at length. The natural history of visual acuity outcome shows a final visual acuity of 20/40 or better in 89% of permanent BRAO cases, 100% of transient BRAO and 100% of nonarteritic CLRAO alone. Cotton wools spots These are common, non-specific acute focal retinal...

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Section: Branch Retinal Arteriolar Occlusionsupporting

confidence: 68%

Acute retinal arterial occlusive disorders

Hayreh

2011

Progress in Retinal and Eye Research

320

309

View full text Add to dashboard Cite

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“…One of the characteristics of idiopathic recurrent BRAOs is segmental branch retinal arteriolar staining in the fluorescein angiograms. 1 , 2 , 3 , 4 , 5 It is not known what causes this staining but vasculitis is the most likely cause. Because the speed of the migration of the fluorescein staining was much slower than the blood flow, Inflammatory cells or deposits of immunocomplexes may contribute to the vasculitis and the formation of thrombi.…”

Section: Discussionmentioning

confidence: 99%

“…It can develop uni- or bilaterally in otherwise healthy patients who also have vestibuloauditory and transient sensorimotor symptoms. 1 , 2 , 3 , 4 , 5 We have followed a patient with this disease for 16 years and found several new findings that might contribute to the etiology of the disease.…”

Section: Introductionmentioning

confidence: 99%

Migration of segmental arteriolar fluorescein staining peripherally in eye with idiopathic recurrent branch retinal arterial occlusion

Kawano

Ito

Haga

et al. 2017

American Journal of Ophthalmology Case Reports

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PurposeTo report a novel finding in a case of idiopathic recurrent branch retinal arterial occlusions.ObservationsWe report our findings in a 31-year-old woman with an idiopathic recurrent branch retinal arterial occlusions (BRAOs) who was followed in our clinic for 16 years. Repeated fluorescein angiographies were performed to evaluate the idiopathic recurrent BRAOs. The findings showed multiple segmental arteriolar staining in the fundus. These staining were found at locations with and without branch retinal arterial occlusions. Repeated fluorescein angiography showed that these staining migrated toward the periphery. The speed of the migration of the staining was about 0.64 ± 0.22 mm/day with a range of 0.43–0.85 mm/day in the posterior pole of the eye. In each of the BRAO, the staining did not cause branch retinal arterial occlusions in the peripheral retina again.Conclusions and importanceSegmental arteriolar staining that migrates towards the periphery may be a clue to the etiology of this disease process.

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“…Recurrent branch retinal artery occlusion (BRAO) is a rare retinal disease that usually occurs in young patients and is characterized as repeated retinal artery occlusion (RAO) in different focal areas. 1 , 2 Unlike permanent BRAO or transient amaurosis fugax, 3 the causes of idiopathic BRAO is unclear. It sometimes happens bilaterally and may accompany with vestibuloauditory or sensorimotor symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…It sometimes happens bilaterally and may accompany with vestibuloauditory or sensorimotor symptoms. 1 , 2 , 4 The visual prognosis is relatively good. Urticaria with recurrent BRAO is an uncommon syndrome characterized by migraine headaches, tinnitus, vertigo, hearing loss, and recurrent BRAO of unknown etiology.…”

Section: Introductionmentioning

confidence: 99%

MultiColor imaging in urticarial vasculitis with recurrent branch retinal artery occlusion in a case with positive toxoplasma IgG and interferon-gamma release assay - Case report

Urticaria in idiopathic bilateral recurrent branch retinal arterial occlusion

Cited by 7 publications

References 6 publications

Acute retinal arterial occlusive disorders

Acute retinal arterial occlusive disorders

Migration of segmental arteriolar fluorescein staining peripherally in eye with idiopathic recurrent branch retinal arterial occlusion

MultiColor imaging in urticarial vasculitis with recurrent branch retinal artery occlusion in a case with positive toxoplasma IgG and interferon-gamma release assay - Case report

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