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)

We described a 67-year-old right handed man with a left internal carotid artery occlusion, who developed monocular photopsia that supervened neovascular glaucoma. He had an antecedent transient motor aphasia. His photopsia, exaggerated by light, persisted intermittently. Orbital bruit was obtained on the left, more clearly during the photopsia. Brain MRI, cerebral angiography, and duplex sonography of carotid and ophthalmic arteries indicated left internal carotid artery (ICA) occlusion with collateral circulation through the ophthalmic artery. Visual evoked potentials (VEPs) revealed a prechiasmal disturbance of the optic pathway of the left side. The patient had carotid endarterectomy of the left ICA, and his visual disturbance has gradually improved. Ocular symptoms due to ICA ischemia are commonly transient visual loss with dark background known as amaurosis fugax. Neovascular glaucoma is sometimes complicated with carotid artery occlusion. However, photopsia associated with carotid artery occlusion is rare. Photopsia mimics scintillating scotomata, but the latter precedes migraine and is biocular and homonymous, ascribable to spreading depression from the occipital lobe. Retinal or prechiasmal optic pathway might be influenced by poor circulation of the ophthalmic artery. In addition, disturbance of light adaptation due to retinal hypoperfusion may be possible reason. Neovascular glaucoma is intractable, once developed. Therefore, atypical scintillating visual disturbance must be recognized as a sign of carotid artery insufficiency and supervened glaucoma to prevent it.
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PMID:[Monocular photopsia preceding with neovascular glaucoma due to internal carotid artery occlusion; a case report]. 874 54

A 52-year-old Chinese gentleman presented with right eye floaters and photopsia over one week. His visual acuities were 20/20 bilaterally. Posterior segment examination showed a right eye swollen optic disc and central retinal vein occlusion (CRVO) associated with an area of subretinal hemorrhage adjacent to the optic disc. Fundus fluorescein (FA) and indocyanine green angiographies (ICGA) of the right eye did not demonstrate choroidal neovascularization (CNV), polypoidal choroidal vasculopathy (PCV), or retinal ischemia. Ultrasound B-scan revealed optic disc drusen (ODD). In view of good vision and absence of CNV, he was managed conservatively with spontaneous resolution after two months. Commonly, ODD may directly compress and mechanically rupture subretinal vessels at the optic disc, resulting in peripapillary subretinal hemorrhage, as was likely the case in our patient. Mechanical impairment of peripapillary circulation also results in retinal ischemia and may trigger the development of choroidal neovascularization (CNV) and/or polypoidal choroidal vasculopathy (PCV), leading to subretinal haemorrhage. Compromise in central venous outflow with increased retinal central venous pressure from the direct mechanical effects of enlarging ODD results in central retinal vein occlusion (CRVO). Patients with subretinal hemorrhage and CRVO from ODD should be monitored closely for the development of potentially sight-threatening complications.
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PMID:Case report of optic disc drusen with simultaneous peripapillary subretinal hemorrhage and central retinal vein occlusion. 2554 21