McGuire Duncan, Calleja Robert, Pai Eric, Bahl Amit
Ascension Providence Hospital, Department of Emergency Medicine, Southfield, Michigan.
Beaumont Health, Department of Emergency Medicine, Royal Oak, Michigan.
Clin Pract Cases Emerg Med. 2024 May;8(2):115-119. doi: 10.5811/cpcem.1520.
Vision loss is a symptom found frequently in patients presenting to the emergency department (ED). Central retinal artery occlusion (CRAO) is an uncommon yet time-sensitive and critical cause of painless vision loss in which delayed diagnosis can lead to significant morbidity. Emergency medicine literature documents the ability to diagnose a CRAO using ultrasound by identifying the hyperechoic thrombus-coined the retrobulbar spot sign.
We present the case of a patient presenting with painless monocular vision loss for which CRAO was diagnosed in the ED using point-of-care ultrasound enhanced by the utilization of serial Doppler examinations as well as calculation of the central retinal artery resistive index.
Despite the pre-existing literature on point-of-care ultrasound investigation of central retinal artery occlusion, there are no emergency medicine case reports describing serial examination of the central retinal artery by spectral Doppler or calculation of arterial resistive index to improve this evaluation and monitor progression of the pathology.
视力丧失是急诊科患者常见的症状。视网膜中央动脉阻塞(CRAO)是一种罕见但对时间敏感且严重的无痛性视力丧失原因,延迟诊断可导致严重的发病率。急诊医学文献记载了通过超声识别高回声血栓(即球后斑点征)来诊断CRAO的能力。
我们报告一例患者,其出现无痛性单眼视力丧失,在急诊科通过床旁超声诊断为CRAO,该超声检查采用了连续多普勒检查以及视网膜中央动脉阻力指数计算进行强化。
尽管已有关于床旁超声检查视网膜中央动脉阻塞的文献,但尚无急诊医学病例报告描述通过频谱多普勒对视网膜中央动脉进行连续检查或计算动脉阻力指数以改善这种评估并监测病情进展。