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Progressive bilateral ocular ischemic syndrome despite previously performed carotid endarterectomy
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Affiliations- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland, Poland
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Abstract
The ocular ischemic syndrome (OIS) is a rare condition with vision-threatening potentials. It is characterized by chronic ischemia of the anterior and/or posterior segment of the eye primarily caused by severe carotid artery occlusive diseases. In this article, we present a case of a 67-year-old male patient presented with the gradual diminution of vision in the right eye for 6 months. The patient had undergone a right internal carotid artery (ICA) endarterectomy (CEA) twice before. On the day of admission, intraocular pressure (IOP) was 34 mm Hg in the right eye (RE) and 20 mm Hg in the left eye (LE). On anterior segment examination, neovascularization of iris in the right eye was noted. On fundoscopy dilated retinal veins, attenuated retinal arteries, blot hemorrhages, cotton wool spots and microaneurysms were present. The patient underwent the appropriate investigations including computed tomography angiography (CTA) of carotid arteries, fundus fluorescence angiography (FFA) and Doppler ultrasound (DUS) of ophthalmic and central retinal arteries, which were all consistent with a diagnosis of bilateral OIS. Intraocular pressure was pharmacologically reduced and stabilized. Subsequently, panretinal photocoagulation (PRP) of peripheral capillary nonperfusion areas was performed in both eyes.
Abstract
The ocular ischemic syndrome (OIS) is a rare condition with vision-threatening potentials. It is characterized by chronic ischemia of the anterior and/or posterior segment of the eye primarily caused by severe carotid artery occlusive diseases. In this article, we present a case of a 67-year-old male patient presented with the gradual diminution of vision in the right eye for 6 months. The patient had undergone a right internal carotid artery (ICA) endarterectomy (CEA) twice before. On the day of admission, intraocular pressure (IOP) was 34 mm Hg in the right eye (RE) and 20 mm Hg in the left eye (LE). On anterior segment examination, neovascularization of iris in the right eye was noted. On fundoscopy dilated retinal veins, attenuated retinal arteries, blot hemorrhages, cotton wool spots and microaneurysms were present. The patient underwent the appropriate investigations including computed tomography angiography (CTA) of carotid arteries, fundus fluorescence angiography (FFA) and Doppler ultrasound (DUS) of ophthalmic and central retinal arteries, which were all consistent with a diagnosis of bilateral OIS. Intraocular pressure was pharmacologically reduced and stabilized. Subsequently, panretinal photocoagulation (PRP) of peripheral capillary nonperfusion areas was performed in both eyes.
Keywords
bilateral ocular ischemic syndrome; IOS; carotid artery occlusion; neovascular glaucoma
About this articleTitle
Progressive bilateral ocular ischemic syndrome despite previously performed carotid endarterectomy
Journal
Issue
Vol 5 (2020): Continuous Publishing
Article type
Case report
Pages
114-119
Published online
2020-11-25
Page views
511
Article views/downloads
512
DOI
Bibliographic record
Ophthalmol J 2020;5:114-119.
Keywords
bilateral ocular ischemic syndrome
IOS
carotid artery occlusion
neovascular glaucoma
Authors
Marta Świerczyńska
Lech Sedlak
Mariola Dorecka
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