1/12. Branch retinal artery occlusion in systemic diseases: a case report.Although branch retinal artery occlusion (BRAO) is a relatively benign disease in terms of permanent visual impairment, the associated systemic diseases confer significant morbidity and mortality. The following systemic disorders can be found among patients presenting with a retinal artery occlusion: hypertension (59%), significant atherosclerotic cardiovascular disease (21%), diabetes mellitus (15% to 21%), left-sided valvular heart disease (5%), and cerebrovascular accidents (5%). These underlying systemic diseases are often responsible for a significant reduction in life expectancy and are in many cases potentially treatable conditions. A thorough cardiovascular examination (including a carotid duplex ultrasonography) may identify these occult diseases, and a prompt and effective treatment may improve the quantity and quality of patients' lives by reducing the risk of further arterial occlusive events.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/12. blindness following a diabetic foot infection: a variant to the 'eye-foot syndrome'?AIMS: The 'eye-foot syndrome' was initially described by Walsh et al. to highlight the important association of foot lesions in patients with diabetic retinopathy. We present a case of a 58-year-old patient with Type 2 diabetes mellitus who developed blindness following endogenous staphylococcal endophthalmitis from an infected foot ulcer. RESULTS: Our case describes the link between the eye and the foot but is somewhat different to the association as described by Walsh et al. Endogenous endophthalmitis is rare with diabetic patients being especially at risk, and we report the first case of endogenous staphylococcal endophthalmitis related to a diabetic foot lesion. CONCLUSIONS: Our case illustrates several important issues in the management of diabetic patients admitted to hospital with infection; the need to thoroughly examine the feet to ascertain any foot lesions and any underlying peripheral vascular disease or peripheral neuropathy, to treat aggressively any infected foot lesions to prevent serious complications of septicaemia and to consider rare conditions like endogenous endophthalmitis in any diabetic patient presenting with acute visual impairment and septicaemia.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/12. Case presentations of retinal artery occlusions.BACKGROUND: Retinal artery occlusions typically result in sudden, unilateral painless loss of vision and may have varying presentations. They are associated with systemic diseases such as atherosclerosis, hypertension, and valvular heart disease. Additional risk factors include diabetes mellitus, cigarette smoking, giant-cell arteritis, and hyperlipidemia. They most often occur in persons 60 to 80 years of age. methods: Four patients have come to our clinics with varying degrees of visual loss as a result of retinal artery occlusions. The types of arteriolar occlusions presented include: precapillary arteriole occlusion, cilioretinal artery occlusion, branch retinal artery occlusion, and central retinal artery occlusion. RESULTS: patients were followed for their ocular involvement, but also included was medical management of the underlying systemic disease condition. Workup of retinal artery occlusion included laboratory testing, carotid duplex scans, and echocardiograms to uncover the possible systemic etiologies of the artery occlusion. CONCLUSION: Optometrists should recognize the signs and symptoms of the various arterial obstructions and refer patients for systemic treatment as indicated. patients who manifest retinal or pre-retinal artery occlusions should undergo thorough systemic evaluations for vascular disease, including: atherosclerotic disease, hypertension, and valvular heart disease.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/12. Posterior ischemic optic neuropathy related to profound shock after penetrating thoracoabdominal trauma.Ischemic optic neuropathy is a rare cause of blindness reported most commonly in association with collagen-vascular diseases, infectious processes, and systemic hypotension related to massive exsanguinating hemorrhage. We report what we believe to be the first case of posterior ischemic optic neuropathy due to perioperative hypotension in a patient who had a penetrating thoracoabdominal injury with massive hemorrhage, severe hypotension, massive microcapillary circulatory leak, multiple system organ failure, and acute respiratory distress syndrome. Although the incidence of postoperative visual loss is low (-0.002%), awareness of this entity must be raised within the trauma surgical community.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
5/12. Bilateral optic nerve infarction following acute systemic hypotension and anemia--a case report.Presented here are case reports of two patients who became completely blind in both eyes following acute systemic hypotension - in one following bouts of vomiting and in the other after repeated gastrointestinal bleeding. Both patients had severe degree of anemia. There were no other risk factors for vascular disease such as arteriosclerosis or vasculitis.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/12. Severe visual loss associated with retinal telangiectasis and facioscapulohumeral muscular dystrophy.Facioscapulohumeral (FSH) muscular dystrophy is known to be associated with retinal telangiectasis. However, there are only few reports of severe visual loss due to exudative complications, so the risk to vision has not been established. Because of the possible therapeutic implications, we have described two cases of young girls who developed FSH muscular dystrophy and exudative retinal detachment due to telangiectasis. In the first patient, the severity of the disease precluded visual recovery despite extensive photo- and cryotherapy. In the other, visual acuity in both affected eyes was retained after treatment. Fundus examinations in young children at risk of having the gene for FSH muscular dystrophy may be justified so that retinal vascular disease can be detected before it becomes untreatable.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/12. Spontaneous bleeding from a normal-appearing iris: an unusual cause of atypical amaurosis fugax.amaurosis fugax, or fleeting loss of vision, is often attributed to embolic retinovascular disease. In this setting, there is appropriate concern for associated cerebrovascular complications. Extensive and expensive vascular evaluation may be indicated. Less often, local ocular abnormalities may mimic embolic visual loss. We describe a case of sudden, transient, monocular visual loss in a 67-year-old woman caused by Valsalva-induced intraocular bleeding from a seemingly normal iris.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/12. sphenoid sinus brown tumor, hypercalcemia, and blindness: an unusual presentation of primary hyperparathyroidism.This is a first report of primary hyperparathyroidism (HPT) masquerading as a destructive fibrous sphenoid sinus "Brown tumor" associated with progressive blindness and hypercalcemia. diagnosis of a Brown tumor was delayed despite serial computerized tomography of the head and repeated transnasal and transethmoid sphenoid biopsies demonstrating diffuse fibrosis. Only detection and medical evaluation of hypercalcemia, demonstrating elevation of both serum calcium and C-terminal parathyroid hormone with an elevated chloride/phosphate ratio, prompted neck exploration, thus confirming a solitary left superior parathyroid adenoma. Postoperative normocalcemia occurred synchronously with the return of light perception and the arrest of sphenoid sinus and parasellar erosion. Although maxillary Brown tumors of secondary HPT have been reported, this is the first report of osteitis fibrosa of the sphenoid sinus. Differential diagnosis of an erosive sphenoid lesion with cranial nerve dysfunction, exclusive of inflammatory or vascular disease, should include sarcoidosis, primary and metastatic sphenoid carcinoma, fibrous dysplasia, giant cell reparative granuloma, midline lethal granuloma, chordoma, and chondrosarcoma. Furthermore, the bony destructive lesions with concomitant hypercalcemia of sarcoidosis and HPT are distinguishable by radiographic and laboratory analyses and by the Dent corticosteroid suppression test. hypercalcemia of primary HPT is associated with elevated serum C-terminal parathormone, osteitis fibrosa, a negative Dent test, and a chloride/phosphate ratio greater than 33 in 94% of primary HPT patients. hypercalcemia of sarcoidosis is associated with a normal or decreased C-terminal parathormone assay and a positive Dent test, as well as elevated serum immunoglobulins and erythrocyte sedimentation rate, and a positive angiotensin-converting enzyme assay.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/12. Transient monocular obscuration--?amaurosis fugax: a case report.A 73-year-old white man with pseudophakia experienced repeated bouts of transient visual loss associated with erythropsia and colour desaturation. A diagnosis of atheromatous carotid vascular disease was considered, prompting carotid angiography, during which time the patient experienced transient aphasia. Subsequent examination during an episode of visual loss showed that a spontaneous anterior chamber haemorrhage was the cause of the visual complaints.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
10/12. Occult retinal and choroidal vascular disease. The value of timed and directed fluorescein angiography.BACKGROUND: Acute vascular disease of the choroid or large vessels of the retina is usually accompanied by funduscopic signs. In instances of monocular visual loss, such objective signs are important diagnostic clues that the pathology is in the eye and not in the optic nerve. methods: fluorescein angiography was timed in a consistent manner, and photographs were taken at two frames per second. orientation of the camera was customized for each patient based on the location of the visual field defect. RESULTS: Eight patients with monocular visual loss were referred because the cause of the visual loss was not evident. In each patient, fluorescein angiography showed vascular disease of either the choroid or retina, despite normal-appearing fundi. CONCLUSIONS: fluorescein angiography can detect otherwise occult vascular disease of the retina or choroid. In eyes with monocular scotomas, the angiogram should be performed with the camera oriented with respect to the location of the visual field defect. Accurately timed, rapid sequence photography provides additional information about rate and symmetry of flow. Focal areas of hypoperfusion often are incidental but deserve added consideration when they correspond to the location of a scotoma.- - - - - - - - - - ranking = 7keywords = vascular disease (Clic here for more details about this article) |
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