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Amaurosis fugax: is it innocuous?
D Rosenthal1, J C Hungerpiller, M E Crispin
1Department of Vascular Surgery, Georgia Baptist Medical Center, Medical College of Georgia, Atlanta.
Annals of Vascular Surgery
|May 1, 1992
Summary
Amaurosis fugax, a transient visual loss, indicates significant carotid artery disease. Carotid endarterectomy significantly reduces stroke risk and long-term morbidity in affected patients.
Area of Science:
- Neurology
- Vascular Surgery
- Ophthalmology
Background:
- Amaurosis fugax (AF) is a transient visual disturbance often caused by carotid artery atherosclerosis.
- Identifying patients at high risk for stroke is crucial for timely intervention.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of carotid endarterectomy (CE) in patients with amaurosis fugax and significant carotid bifurcation disease.
Main Methods:
- A 10-year retrospective study of 103 patients with amaurosis fugax.
- Patients were divided into two groups: those undergoing CE (n=62) and a non-operated control group (n=41) with similar carotid pathology.
- Outcomes including recurrent AF, transient ischemic attacks (TIAs), and strokes were compared.
Main Results:
- The operated group experienced significantly lower cumulative morbidity (6.4%) compared to the non-operated group (21.9%, p=0.02).
- Operated patients had one stroke (1.6%), while the non-operated group had two strokes (4.8%), one fatal.
- Non-operated patients had higher rates of ongoing AF symptoms and TIAs.
Conclusions:
- Carotid endarterectomy is recommended for patients with amaurosis fugax and demonstrable carotid bifurcation disease.
- Amaurosis fugax serves as a critical warning sign for potential monocular blindness and stroke.