Lee Sang Joon, Kim Soo Young, Kim Shin Dong
Department of Ophthalmology, College of Medicine, Kosin University, Busan, Korea.
Korean J Ophthalmol. 2009 Mar;23(1):53-6. doi: 10.3341/kjo.2009.23.1.53. Epub 2009 Mar 9.
We describe two cases of branch retinal artery occlusion (BRAO) after carotid artery (CA) stenting. Case 1: A 57-year-old man diagnosed with left neovascular glaucoma was admitted to our department for trabeculectomy (He had complained of decreased visual acuity (VA) in the left eye for a month). A preoperative neck angio CT scan showed bilateral CA stenosis. After CA stenting, he contracted visual defects on the right superior area of his right eye. Upon examination, VA with correction was found to be 1.0 (OD), but right fundoscopy revealed ischemic retina whitening along the inferior temporal arcade. Case 2: A 64-year-old man received left CA stenting for severe stenosis in the Department of Neurology. The next day, he was referred to us for acute onset of a left naso-inferior visual field defect. Upon initial examination, his VA with correction was 0.8/0.16 (OD/OS) and fundoscopy revealed ischemic retina whitening at the superior posterior pole in the left eye.It was not necessary to treat the BRAO in these cases because the foveal capillary network was not invaded at 2 month follow ups, VA was preserved in both cases.In conclusion, ophthalmic evaluation is important after CA stenting because of a possible embolic occlusion of the retinal artery.
我们描述了两例颈动脉支架置入术后发生视网膜分支动脉阻塞(BRAO)的病例。病例1:一名57岁男性,诊断为左新生血管性青光眼,因小梁切除术入住我科(他曾抱怨左眼视力下降一个月)。术前颈部血管CT扫描显示双侧颈动脉狭窄。颈动脉支架置入术后,他右眼右上象限出现视觉缺损。检查发现,矫正视力为1.0(右眼),但右眼眼底检查显示颞下弓状缘有缺血性视网膜变白。病例2:一名64岁男性因严重狭窄在神经科接受了左颈动脉支架置入术。第二天,他因急性发作左鼻下视野缺损被转诊至我科。初诊时,他的矫正视力为0.8/0.16(右眼/左眼),眼底检查显示左眼后极上方有缺血性视网膜变白。在这些病例中,由于随访2个月时黄斑毛细血管网未受侵犯,且两例患者的视力均得以保留,因此无需对BRAO进行治疗。总之,由于可能发生视网膜动脉栓塞性阻塞,颈动脉支架置入术后的眼科评估很重要。