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Branch retinal artery occlusion associated with directional coronary atherectomy after percutaneous transluminal
V Filatov1, D Tom, G Alexandrakis
1Department of Ophthalmology and Visual Science, Yale University School of Medicine, CT, USA.
Insights
Atherectomy, a procedure to clear arteries, can rarely cause branch retinal artery occlusion, leading to vision loss. This case highlights the risk of retinal microinfarctions following the procedure.
Area of Science:
- Ophthalmology
- Cardiology
- Vascular Surgery
Background:
- Directional coronary atherectomy is a procedure to remove plaque from coronary arteries.
- Complications can arise, necessitating further interventions.
Observation:
- A 51-year-old male experienced sudden vision loss in his right eye post-procedure.
- Ophthalmologic examination revealed Hollenhorst plaques in the retinal vasculature.
Findings:
- The patient presented with decreased visual acuity (20/30) and an inferior visual field defect.
- Fluorescein angiography and Doppler ultrasound confirmed the diagnosis of branch retinal artery occlusion.
Implications:
- Atherectomy carries a risk of embolic events, potentially affecting the retinal vasculature.
- Ophthalmologists should consider retinal artery occlusion in patients with visual disturbances after atherectomy.
- This case underscores the importance of a multidisciplinary approach in managing patients undergoing vascular procedures.
Purpose:
To report a case of branch retinal artery occlusion after atherectomy.
Methods:
A 51-year-old man complained of visual loss in the right eye after directional coronary atherectomy, performed secondary to a complicated percutaneous transluminal coronary angioplasty. He underwent a full ophthalmologic examination, including fluorescein angiography and Doppler ultrasound.
Results:
Visual Acuity was 20/30 with an inferior scotoma present in the right eye. There were three Hollenhorst plaques present inside the superotemporal vascular arcade.
Conclusions:
There is a small but definite risk of retinal microinfarctions after atherectomy.