[Developmental ophthalmic ischemia. Regression after emergency extra-intracranial anastomosis]

Recently several publications have insisted on the ability of E.I.C.B. in reversing ocular manifestations due to chronic ophthalmic ischemia, when surgical carotid desobstruction is considered impossible or hazardous. Revascularization with E.I.C.B. can also be useful--on emergency --in case of "in evolution" ophthalmic ischemia, due to low pressure perfusion in the carotid-ophthalmic territory, to save vision. The authors report the case of a patient, presenting an optico-pyramidal syndrome "in evolution", secondary to occlusion of the left carotid artery associated with stenotic lesions in the ophthalmic artery, reversed by E.I.C.B. performed on emergency. Left visual acuity and diastolic retinian arterial pressure --respectively inferior to 1/10 and unmeasurable, before operation--raised up to 6/10 and 18 mmHg within the first twelve post-operative days and reached 8/10 and 38 mmHg after eleven weeks. This case report aims at pointing out the capacity of E.I.C.B. performed on emergency in reversing ophthalmic ischemia--"in evolution"--before constitution of irreversible lesions.