Embolic cilioretinal artery occlusion due to carotid artery dissection

Am J Ophthalmol. 2004 Sep;138(3):496-8. doi: 10.1016/j.ajo.2004.04.018.

Abstract

Purpose: To report a case of embolic cilioretinal artery occlusion caused by carotid artery dissection.

Design: Interventional case report.

Methods: A 38-year-old woman presented with acute visual loss in her right eye. Funduscopy showed a cilioretinal artery occlusion, which was confirmed by a fluorescein angiography. An embolus was found in the distal segment of the vessel.

Results: Color Doppler images of right internal carotid artery (ICA) disclosed a pseudolumen, suggesting a diagnosis of carotid dissection. Retrobulbar color Doppler image showed relative low flow velocity in the ophthalmic artery without flow reversal. Magnetic resonance angiography and cerebral angiogram showed total occlusion of the right ICA. Follow-up visual field examination revealed an inferior central defect fed by the cilioretinal artery.

Conclusion: The pathogenesis of retinal artery occlusion caused by carotid dissection may be embolic or hemodynamic. In our case, a permanent visual defect was related to embolic occlusion of the cilioretinal artery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Blood Flow Velocity
  • Carotid Artery, Internal, Dissection / complications*
  • Carotid Artery, Internal, Dissection / diagnosis
  • Carotid Artery, Internal, Dissection / drug therapy
  • Cerebral Angiography
  • Ciliary Arteries / pathology*
  • Embolism / diagnosis
  • Embolism / drug therapy
  • Embolism / etiology*
  • Female
  • Fluorescein Angiography
  • Heparin / therapeutic use
  • Humans
  • Magnetic Resonance Angiography
  • Ophthalmic Artery / physiopathology
  • Retinal Artery Occlusion / diagnosis
  • Retinal Artery Occlusion / drug therapy
  • Retinal Artery Occlusion / etiology*
  • Ultrasonography, Doppler, Color
  • Visual Fields

Substances

  • Anticoagulants
  • Heparin