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Vascular emergencies in neuro-ophthalmology.
Eugenia Raluca Iorga1,2, Dănuț Costin1,2
1Department of Ophthalmology, "N. Oblu" Clinical Emergency Hospital, Iași, Romania.
Romanian Journal of Ophthalmology
|December 28, 2020
Summary
Carotid artery obstruction, often from atheromatous plaque, is the primary cause of ocular ischemic syndrome (OIS). Recognizing OIS symptoms like transient monocular blindness is crucial for prompt, multi-specialty management.
Area of Science:
- Neurology
- Ophthalmology
- Vascular Medicine
Background:
- Cerebral vascularization relies on internal carotids, vertebral arteries, and the Willis circle.
- Carotid artery obstruction is the most common cause of ocular ischemic syndrome (OIS).
- Obstructions stem from atheromatous plaque, external compression, arteritis, or dissection.
Purpose of the Study:
- To highlight the link between carotid artery pathology and ocular ischemic syndrome.
- To detail the signs, symptoms, and causes of OIS.
- To emphasize the importance of early recognition and multi-specialty management for OIS.
Main Methods:
- Review of literature on carotid artery diseases and their ocular manifestations.
- Analysis of clinical presentations associated with severe ocular hypoperfusion.
- Discussion of diagnostic and management strategies for OIS.
Main Results:
- Atheromatous lesions of the carotid artery are the most frequent cause of OIS.
- OIS symptoms include transient monocular blindness (TMB), persistent monocular blindness, ocular ischemia, Claude Bernard Horner syndrome (CBH), and oculomotor palsies.
- Other vascular emergencies include carotid artery dissection, Horton arteritis, aneurysms, and carotid-cavernous fistula.
Conclusions:
- Carotid artery pathology is a critical, potentially life-threatening condition.
- Prompt recognition of OIS signs and symptoms is vital for patient outcomes.
- A multi-specialty approach is essential to prevent misdiagnosis and optimize patient management.
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