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      Incongruent Results between Carotid Angiography and Fluorescein Angiography in Patients with Ocular Ischemic Syndrome

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      https://www.riss.kr/link?id=A108602316

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      다국어 초록 (Multilingual Abstract)

      Purpose: We report two cases of ocular ischemic syndrome (OIS) with incongruent results between carotid angiography and fluorescein angiography (FA).
      Case summary: In the first case, a 61-year-old man visited our clinic complaining of amaurosis fugax-like symptoms in the left eye for 1 month. His corrected visual acuity (CVA) was 20/25 in the left eye. Fundus examination did not reveal any abnormalities. Seventeen days after presentation, his CVA had decreased to 20/40. FA showed delayed choroidal filling and arm-to-retina time. Magnetic resonance angiography revealed severe stenosis of the left carotid artery. Carotid stenting was performed immediately. Seventeen days after the intervention, his CVA decreased to finger count of 40 cm, and FA findings showed delayed blood flow. However, carotid angiography revealed good patency of the internal carotid and ophthalmic arteries. In the second case, a 69-year-old man presented to our clinic with eye problems caused by diabetes. He had recently been diagnosed with total occlusion of the left internal carotid artery. Carotid angiography revealed well-developed collateral circulation and no need for carotid intervention. His visual acuity was 20/20 in both eyes. Three months later, his CVA decreased to finger count of 30 cm in the left eye. FA revealed delayed choroidal filling and arm-to-retina time and disc neovascularization. However, carotid angiography showed good flow into the ophthalmic artery.
      Conclusions: These cases show that FA may not be correlated with carotid angiography findings in patients with OIS. We suggest that FA is an essential tool for diagnosing OIS, even if carotid angiography shows intact flow into the ophthalmic artery.
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      Purpose: We report two cases of ocular ischemic syndrome (OIS) with incongruent results between carotid angiography and fluorescein angiography (FA). Case summary: In the first case, a 61-year-old man visited our clinic complaining of amaurosis fugax-...

      Purpose: We report two cases of ocular ischemic syndrome (OIS) with incongruent results between carotid angiography and fluorescein angiography (FA).
      Case summary: In the first case, a 61-year-old man visited our clinic complaining of amaurosis fugax-like symptoms in the left eye for 1 month. His corrected visual acuity (CVA) was 20/25 in the left eye. Fundus examination did not reveal any abnormalities. Seventeen days after presentation, his CVA had decreased to 20/40. FA showed delayed choroidal filling and arm-to-retina time. Magnetic resonance angiography revealed severe stenosis of the left carotid artery. Carotid stenting was performed immediately. Seventeen days after the intervention, his CVA decreased to finger count of 40 cm, and FA findings showed delayed blood flow. However, carotid angiography revealed good patency of the internal carotid and ophthalmic arteries. In the second case, a 69-year-old man presented to our clinic with eye problems caused by diabetes. He had recently been diagnosed with total occlusion of the left internal carotid artery. Carotid angiography revealed well-developed collateral circulation and no need for carotid intervention. His visual acuity was 20/20 in both eyes. Three months later, his CVA decreased to finger count of 30 cm in the left eye. FA revealed delayed choroidal filling and arm-to-retina time and disc neovascularization. However, carotid angiography showed good flow into the ophthalmic artery.
      Conclusions: These cases show that FA may not be correlated with carotid angiography findings in patients with OIS. We suggest that FA is an essential tool for diagnosing OIS, even if carotid angiography shows intact flow into the ophthalmic artery.

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      참고문헌 (Reference)

      1 한용섭 ; 유웅선 ; 정인영 ; 박종문, "경동맥 스텐트 삽입술로 완치된 안허혈증후군 1례" 대한안과학회 51 (51): 447-452, 2010

      2 Brown GC, "The ocular ischemic syndrome. clinical, fluorescein angiographic and carotid angiographic features" 11 : 239-251, 1988

      3 Sivalingam A, "The ocular ischemic syndrome. III. visual prognosis and the effect of treatment" 15 : 15-20, 1991

      4 Hill MD, "Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial(CREST)" 126 : 3054-3061, 2012

      5 Wilentz JR, "Retinal embolization during carotid angioplasty and stenting : mechanisms and role of cerebral protection systems" 56 : 320-327, 2002

      6 Brown GC, "Retina" Elsevier 2013

      7 Staurenghi G, "Retina" Elsevier 2013

      8 Johnson RN, "Retina" Elsevier 2013

      9 Jim J, "Percutaneous carotid artery stenting [Internet]"

      10 Hedges TR Jr, "Ophthalmoscopic findings in internal carotid artery occlusion" 55 : 1007-1012, 1963

      1 한용섭 ; 유웅선 ; 정인영 ; 박종문, "경동맥 스텐트 삽입술로 완치된 안허혈증후군 1례" 대한안과학회 51 (51): 447-452, 2010

      2 Brown GC, "The ocular ischemic syndrome. clinical, fluorescein angiographic and carotid angiographic features" 11 : 239-251, 1988

      3 Sivalingam A, "The ocular ischemic syndrome. III. visual prognosis and the effect of treatment" 15 : 15-20, 1991

      4 Hill MD, "Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial(CREST)" 126 : 3054-3061, 2012

      5 Wilentz JR, "Retinal embolization during carotid angioplasty and stenting : mechanisms and role of cerebral protection systems" 56 : 320-327, 2002

      6 Brown GC, "Retina" Elsevier 2013

      7 Staurenghi G, "Retina" Elsevier 2013

      8 Johnson RN, "Retina" Elsevier 2013

      9 Jim J, "Percutaneous carotid artery stenting [Internet]"

      10 Hedges TR Jr, "Ophthalmoscopic findings in internal carotid artery occlusion" 55 : 1007-1012, 1963

      11 Terelak-Borys B, "Ocular ischemic syndrome-a systematic review" 18 : RA138-44, 2012

      12 Mizener JB, "Ocular ischemic syndrome" 104 : 859-864, 1997

      13 Mendrinos E, "Ocular ischemic syndrome" 55 : 2-34, 2010

      14 Adla T, "Multimodality imaging of carotid stenosis" 24 : 179-184, 2015

      15 Sailer AM, "Cost-effectiveness of CTA, MRA and DSA in patients with non-traumatic subarachnoid haemorrhage" 4 : 499-507, 2013

      16 Luo J, "Clinical analysis of 42 cases of ocular ischemic syndrome" 2018 : 2606147-, 2018

      17 김영휘 ; 성미선 ; 박상우, "Clinical Features of Ocular Ischemic Syndrome and Risk Factors for Neovascular Glaucoma" 대한안과학회 31 (31): 343-350, 2017

      18 Sturrock GD, "Chronic ocular ischaemia" 68 : 716-723, 1984

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