Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of arteriosclerotic posterior ischemic optic neuropathy without optic disc edema is described and documented photographically. The development of optic disc cupping and pallor with ischemia in this patient supports the vascular basis for development of similar cupping and pallor in open angle glaucoma and low tension glaucoma.
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PMID:Development of cupping and pallor in posterior ischemic optic neuropathy. 688 56

An acute loss of vision accompanied by signs of optic nerve head ischemia in an elderly patient should alert the examiner to suspect the presence of temporal arteritis until it can be proven otherwise. The patient presented here had ischemic optic neuropathy that was initially thought to be due to temporal arteritis, but eventually was proven to be associated with pronounced atherosclerotic aortic arch disease. The diagnosis was complicated by the severe loss of vision and by an elevated erythrocyte sedimentation rate (ESR). A temporal artery biopsy was normal, and other findings implicated the pronounced diffuse atherosclerosis as the cause of the ischemia of the optic nerve head. Therapy was directed toward the vascular occlusive disease, and involved an aortoinnominate bypass graft.
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PMID:Complicated aortic arch syndrome and ischemic optic neuropathy presenting as giant cell (temporal) arteritis. 703 43

Giant-cell arteritis is a polysymptomatic disease of the elderly. Systemic symptomatology includes headaches, arthralgias, myalgias, tender temporal arteries, jaw claudication, low-grade fever, anemia, anorexia, malaise, and weight loss. Visual loss from anterior ischemic optic neuropathy and diplopia resulting from ischemia of the ocular muscles represents the major ocular manifestations of giant cell arteritis. When the diagnosis is suspected, blood for a sedimentation rate should be drawn, and, if it confirms the clinical impression, high dose prednisone should be started immediately and a temporal artery biopsy performed at a later date. Only by asking the proper questions and suspecting the diagnosis will this preventable form of blindness receive the prompt attention it deserves.
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PMID:Giant-cell arteritis. Signs and symptoms. 715 21

Four unusual patients had bilateral anterior ischemic optic neuropathy (AION). In all four cases, AION developed in the first eye with the classic presentation. The fellow eye had symptomless optic disc edema (ODE) with no subjective or objective visual loss initially, but the classic AION clinical picture developed later on. The findings indicate that symptomless ODE may precede the visual loss in AION and could constitute the earliest sign of this disease. Since ODE in AION is due to axoplasmic flow stasis that, by itself, does not produce visual loss (this is produced by disruption of visual impulse transmission), this would suggest that mild optic nerve head ischemia interferes with axoplasmic flow without disrupting the visual impulse; however, more severe ischemia would disrupt both. Possible effects of various grades of acute optic nerve head ischemia are discussed.
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PMID:Anterior ischemic optic neuropathy. V. Optic disc edema an early sign. 723

3 patients (5 eyes) with posterior ischemic optic neuropathy (PION) are presented. PION is a distinct clinical entity, caused by ischemia of the posterior part of the optic nerve. These eyes presented with a visual acuity varying from normal to no light perception, optic nerve-related visual field defects, and no fundus abnormality (on ophthalmoscopy or fluorescein fundus angiography) at the onset of the disease and for about a month thereafter, but after about 5-6 weeks the optic disc developed atrophic changes. The pathogenesis, differential diagnosis and possible management of PION are discussed.
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PMID:Posterior ischemic optic neuropathy. 726 96

Six cases of vascularly induced disc edema are described. Patients were all fairly young, with only slight and mostly transient visual decrease in spite of impaired pupillary reflexes (three cases) and altitudinal field defects. Bilateral, though asymmetric, involvement was detected in three cases. The fundus showed a usually pale disc; the emerging arteries always presented segmental constrictions and signs of inflammation (sheathing) or sclerosis (increased reflexes). The peripapillary retina showed splinter hemorrhages and cotton-wool spots. Fluorescein angiography typically showed slow retinal circulation times with arterial laminar flow often persisting well into the venous stages. The disc and peripapillary choroid showed patchy ischemia. Fluorescein leaked at the disc in all cases, often in an irregular fashion and with a tendency for dye to run along the initial arterial segments. History and medical workups were noncontributory. Three patients with evidence of inflammatory arterial disease (vitreous cells, periarterial cuffing, and fluorescein staining of the vessel walls) improved with systemic steroids. In the remaining three the papilloarterial ischemia was diagnosed as caused by premature arteriosclerosis. This vascular condition differs from ischemic optic neuropathy, in which retinal arteries are not obviously involved, and from papillophlebitis, in which the retinal vascular involvement, when present, is limited to the veins.
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PMID:Papilloarterial Ischemia. 729 38

Pattern shift visual evoked response (PSVER) latency has been shown to be an extremely sensitive but nonspecific measure of optic nerve dysfunction. The test has been most useful in detecting unsuspected demyelinating lesions of the optic nerve, but abnormal results have been reported in a variety of other conditions affecting the optic nerve, including ischemic optic neuropathy. We report a patient with left internal carotid artery occlusion, possibly secondary to neck trauma, with normal ophthalmological examination and abnormal PSVER. The suggested mechanism is subclinical optic nerve ischemia due to decreased blood flow in the ophthalmic artery. PSVER may have value as a sensitive indicator of internal carotid artery disease.
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PMID:Pattern shift visual evoked response in carotid occlusion. 738 51

Color Doppler imaging of the orbit shows promise in evaluation of several types of orbital abnormalities. The most promising use is for evaluation of vascular disorders. Screening for orbital varices and cavernous-carotid fistulas is easily accomplished. Color Doppler imaging can also be useful in diagnosis of ocular ischemia, central retinal vessel occlusion, and anterior ischemic optic neuropathy. In cases of inflammatory disease, it may be helpful in searching for complications of infection and in monitoring the size of fluid collections. In cases of tumors, color Doppler imaging can be used to monitor lesion size and in surgical planning. More work needs to be done to determine the role of color Doppler imaging in evaluation of trauma and congenital abnormalities. An understanding of the basic anatomy of the orbit, examination techniques, and common disease processes in the orbit will allow the radiologist to offer this potentially valuable modality to referring clinicians.
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PMID:Color Doppler US of the orbit. 762 65

The aim of this investigation was to correlate the clinical and histological findings in 85 consecutive patients with temporal arteritis. Particular attention was given to a possible correlation between optic nerve involvement and the presence of giant cells upon histological examination. Severe ischemia as in anterior ischemic optic neuropathy and central retinal arterial occlusion was presented in 37 patients (43%). Giant cells were definitely observed in 32 biopsy specimens (37.6%) and suspected in 11 additional specimens (13%): In 42 specimens (49.3%) no giant cells were present. Our study showed no correlation between the occurrence of severe optic nerve involvement and the histological findings with regard to giant cells. Statistical evaluation also failed to show a significant correlation between the frequency of pain and jaw claudication and the respective histological findings regarding giant cells. In the biopsy specimen of one patient, numerous eosinophilic granulocytes had infiltrated the vessel wall.
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PMID:Temporal arteritis. Comparison of histological and clinical findings. 797 62

In low-tension glaucoma (LTG), nerve-fiber-bundle defects are assumed to result from ischemia of the choroidal branches of the posterior ciliary arteries, due either to local vascular changes or, presumably, hemodynamically occlusive carotid artery disease. To study the possible hemodynamical origin of LTG, we examined and compared, clinically and by ultrasound (continuous-wave Doppler and duplex-scanning), the extracranial carotid arteries of (1) 21 patients (34 eyes) with LTG, (2) 48 patients (49 eyes) with retinal ischemic syndromes (RIS), and (3) 15 patients (17 eyes) with anterior ischemic optic neuropathy (AION). High-grade stenoses and occlusions of the internal carotid arteries ipsilateral to the affected eyes were significantly more frequent in the RIS patients (17 of 49) than in the LTG patients (2 of 34; P < .01) and the AION patients (0 of 17; P < .01). Among our relatively small group of LTG patients, we found no striking evidence supporting a hemodynamic origin of LTG.
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PMID:Low-tension glaucoma: a comparative study with retinal ischemic syndromes and anterior ischemic optic neuropathy. 811 99


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