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Ischemic optic neuropathy associated with retinal embolism.

R L Tomsak

    American Journal of Ophthalmology
    |May 15, 1985
    PubMed
    Summary

    Ischemic optic neuropathy (ION) can be caused by a shower of emboli to the eye. This rare condition was observed in three patients following cardiac procedures.

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    Area of Science:

    • Ophthalmology
    • Cardiology
    • Neurology

    Background:

    • Ischemic optic neuropathy (ION) is a leading cause of non-arteritic visual impairment in older adults.
    • Coronary artery bypass grafting (CABG) and cardiac catheterization are common cardiovascular procedures.
    • Diffuse atherosclerotic disease and systemic hypertension are known risk factors for vascular events.

    Observation:

    • Three patients (55-year-old male, 64-year-old female, 68-year-old female) developed ION.
    • Two patients experienced visual loss post-coronary artery bypass grafting (CABG) with diffuse atherosclerotic disease and bilateral retinal emboli.
    • The third patient developed ION with ipsilateral retinal emboli after cardiac catheterization, with hypertension as her sole additional risk factor.

    Findings:

    • The clinical presentation suggests a potential causal link between showers of emboli and the development of ION.
    • Retinal emboli were a consistent finding in all affected patients, indicating ocular vascular compromise.
    • The occurrence of ION following invasive cardiac procedures highlights a potential iatrogenic complication.

    Implications:

    • Ophthalmologists and cardiologists should be aware of this rare but serious complication.
    • Screening for retinal emboli may be warranted in patients presenting with ION after cardiac procedures.
    • Further research is needed to elucidate the precise mechanisms and incidence of procedure-associated embolic ION.

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