Chatziralli Irini P, Parikakis Efstratios A, Mitropoulos Panagiotis G
2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens - Greece.
Eur J Ophthalmol. 2015 Jul 30;25(5):e88-90. doi: 10.5301/ejo.5000608.
To present the case of a man with branch retinal artery occlusion (BRAO) and concomitant patent foramen ovale (PFO), which was first diagnosed during the evaluation of BRAO.
A 35-year-old man presented with blurred vision in the left eye for 2 days. His best-corrected visual acuity (BCVA) was 6/6 in the right eye and 6/12 in the left eye. He had no ophthalmic or medical history.
Ophthalmologic examination revealed a left inferior BRAO, confirmed by fluorescein angiography. The patient underwent a thorough diagnostic workup. Cardiologic examination with transesophageal echocardiography revealed a right-to-left shunt across a PFO. The patient was treated with clopidogrel and at the 15-day review, BCVA in his left eye was 6/7.5 and the retinal edema was resolved, as detected on optical coherence tomography, but relative afferent pupillary defect was persistent. The patient had developed no other embolic event at the 9-month follow-up, having undergone an operation for PFO repair.
Patent foramen ovale, although usually asymptomatic, should be considered among the potential causes of BRAO, especially in young patients. Prompt diagnosis and liaison with cardiologists is important to help prevent ocular or systemic embolic events and associated morbidity.
报告一例视网膜分支动脉阻塞（BRAO）合并卵圆孔未闭（PFO）的病例，该病例在BRAO评估过程中首次被诊断出来。
一名35岁男性因左眼视力模糊2天前来就诊。他的最佳矫正视力（BCVA）右眼为6/6，左眼为6/12。他无眼科或内科病史。
眼科检查发现左眼下方存在BRAO，荧光素血管造影证实了这一点。患者接受了全面的诊断检查。经食管超声心动图的心脏检查显示存在通过PFO的右向左分流。患者接受了氯吡格雷治疗，在15天复查时，其左眼BCVA为6/7.5，光学相干断层扫描显示视网膜水肿已消退，但相对性传入瞳孔障碍仍然存在。在9个月的随访中，患者在接受PFO修复手术后未发生其他栓塞事件。
卵圆孔未闭虽然通常无症状，但在BRAO的潜在病因中应予以考虑，尤其是在年轻患者中。及时诊断并与心脏病专家联系对于预防眼部或全身性栓塞事件及相关发病率很重要。
