Hwang Jiunn-Feng, Chen San-Ni, Chiu Shin-Lin, Wu Shey-Lin
Department of Ophthalmology, Cahghua Christian Hospital, 135 Nan-Siao Street, Chang-hua 500, Taiwan.
Am J Ophthalmol. 2004 Sep;138(3):496-8. doi: 10.1016/j.ajo.2004.04.018.
To report a case of embolic cilioretinal artery occlusion caused by carotid artery dissection.
Interventional case report.
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.
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.
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.
报告一例由颈动脉夹层引起的栓子性睫状视网膜动脉阻塞病例。
介入病例报告。
一名38岁女性因右眼急性视力丧失就诊。眼底检查显示睫状视网膜动脉阻塞,荧光素血管造影证实了这一情况。在血管远端发现一个栓子。
右侧颈内动脉彩色多普勒图像显示有一个假腔,提示颈动脉夹层诊断。球后彩色多普勒图像显示眼动脉血流速度相对较低且无血流逆转。磁共振血管造影和脑血管造影显示右侧颈内动脉完全闭塞。随访视野检查发现由睫状视网膜动脉供血的中心下方缺损。
颈动脉夹层导致视网膜动脉阻塞的发病机制可能是栓塞性或血流动力学性的。在我们的病例中,永久性视力缺陷与睫状视网膜动脉的栓塞性阻塞有关。