[Risk factors in patients with amaurosis fugax]

In the diagnosis of retinal and cerebral vascular occlusion and migraine amaurosis fugax may be an important symptom. To evaluate the relation between cardiovascular diseases and amaurosis fugax we investigated the risk factors in patients with amaurosis fugax.

Twenty-four patients (14 m, 10 f; aged 22 to 84 years; mean: 55 +/- 19 years) with amaurosis fugax were included in this study. All patients underwent a detailed clinical and ophthalmological examination, including video fluorescein angiography shortly after the event.

The duration of symptoms ranged from 30 seconds to 30 minutes (median: 3 minutes). Additional acute symptoms were headache in eight patients and tinnitus in one patient. Visual acuity showed no difference between the effected and the fellow eye. Intraocular pressure was normal in all eyes. Video fluorescein angiography revealed normal retinal perfusion times in all cases (arm-retina-time: 12.9 +/- 3.8 s; arteriovenous passage time: 1.8 +/- 0.7 s). Cardiovascular risk factors were present in all patients: 58% of the patients suffered from arterial hypertension, 8% of the patients from diabetes mellitus. Hyperlipidaemia was diagnosed in 17% of the patients, 46% of the patients were smokers. A history of cardiovascular disease (e.g. myocardial infarction, vitium, arrhythmia) was found in 58% of the patients. Cerebrovascular disease was diagnosed in 54% of the patients (migraine: 33%).

The ophthalmologic examination especially the fluorescein angiography revealed no pathologic findings in patients with amaurosis fugax. The risk factor distribution corresponded to data found in patients with retinal artery occlusion.