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Related Experiment Videos

The management of acute visual failure

S H Wray1

  • 1Harvard Medical School, Department of Neurology, Massachusetts General Hospital, Boston 02114.

Journal of Neurology, Neurosurgery, and Psychiatry
|March 1, 1993
PubMed
Summary
This summary is machine-generated.

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This review details diagnosing and managing acute visual failure from ocular strokes like central retinal artery (CRA) occlusion and anterior ischemic optic neuropathy (AION). Prompt diagnosis and risk factor management are key to preventing vision loss.

Area of Science:

  • Ophthalmology
  • Neurology
  • Vascular Medicine

Background:

  • Acute visual failure can result from ocular strokes, including central retinal artery (CRA) occlusion, branch retinal artery (BRA) occlusion, and anterior ischemic optic neuropathy (AION).
  • Timely diagnosis and management are crucial for preserving vision and preventing contralateral eye involvement.

Purpose of the Study:

  • To review the clinical manifestations and management strategies for ocular strokes.
  • To outline a comprehensive diagnostic approach for patients presenting with acute visual failure.

Main Methods:

  • Systematic review of literature on ocular strokes and acute visual failure.
  • Detailed examination including vital signs, funduscopy, and laboratory tests (CBC, coagulation profile, ESR, lipids, antiphospholipid antibodies).

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  • Non-invasive investigations such as carotid Doppler ultrasonography, oculoplethysmography, phonoangiography, B-Scan ultrasonography, and echocardiogram.
  • Invasive investigations including temporal artery biopsy and carotid arteriogram, with MRA as a screening tool.
  • Fluorescein angiography (FFA) for specific indications like suspected ophthalmic artery occlusion or embolic AION.

    • Main Results:

    • Diagnostic process emphasizes meticulous attention to systemic and ocular findings.
    • A combination of non-invasive and, in selected cases, invasive tests aids in diagnosis.
    • Treatment strategies vary based on the specific condition, including emergency measures for CRA occlusion and systemic corticosteroids for arteritis-related cases.

    Conclusions:

    • Effective management of acute visual failure requires a thorough diagnostic workup to identify the underlying cause of ocular stroke.
    • Treatment focuses on immediate interventions to restore blood flow, manage inflammation, and address underlying risk factors to prevent recurrence and protect vision.