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Idiopathic Central Retinal Artery Occlusion: Case Report and Presentation of a General Guide to Therapy

Idiopathic Central Retinal Artery Occlusion: Case Report and Presentation of a General Guide to... Abstract The purpose of this paper is to report an unusual case of idiopathic central retinal artery occlusion in a young man who experienced remarkable recovery of vision and to present a comprehensive therapeutic approach to this clinical entity. Report of Case A 20-year-old Caucasian male, always in good general health, with no previous ocular or neurologic symptoms, experienced sudden loss of vision in the right eye while calmly walking.When first examined approximately 80 minutes later, the patient had no light perception in the right eye except in the temporal periphery where he could detect finger motions. He presented the classical picture of central retinal artery occlusion, including a cherry-red macula with surrounding intense edema. There was apparent stasis in all arterioles. The veins were smaller than those of the left eye, and there was intermittent tumbling of red cell clumps into the physiologic cup as if they were being References 1. Admission height and weight were 69 inches and 225 pounds, respectively. 2. Transient faint pulsations may be observed even in total obstruction as the blood compressed in the vessel distal to the obstruction is advanced by the pulse pressure transmitted through the obstruction. This may be less transient the more proximal the site of the obstruction. 3. Such as acetylcholine, aminophylline, papaverine, tolazoline or nicotinic acid. 4. This temporal island is to be distinguished from the frequently found islands of eccentric tubular field corresponding to small areas of peri-papillary retina whose function is attributed to vascular supply via small branches from the arterial circle of Zinn. 5. de Schweinitz, G. E., and Holloway, T. B.: Sudden Obstruction of the Central Artery of the Retina , Trans. Amer. Ophthal. Soc. 11:471, 1908. 6. Coverdale, H. V.: The Cause and Results of Obstruction of the Central Artery of the Retina , Brit. J. Ophthal. 13:529, 1929.Crossref 7. Werner, L.: On Vascular and Other Retinal Changes Associated with General Disease , Trans. Ophthal. Soc. U.K. 33:9, 1913. 8. Werner, L.: Bilateral Obstruction of the Central Artery of the Retina , Trans. Ophthal. Soc. U.K. 51:654, 1931. 9. Guillette, J. L., and Mayer, W.: Thrombosis of the Central Retinal Artery , Amer. J. Ophthal. 37:578, 1954. 10. Knapp, A.: Embolism of a Branch of the Retinal Artery with Hemorrhagic Infarctus in the Retina , Arch. Ophthal. 1:64, 1869. 11. Coston, T. O.: Ocular Symptoms of Stellate Ganglion Block: Its Use in the Treatment of Occlusion of the Central Retinal Artery , Amer. J. Ophthal. 34:1289, 1951. 12. Wolff, E.: The Anatomy of the Eye and Orbit , Fourth Edition, New York, Blakiston Co., Division of McGraw-Hill Book Co., Inc., 1955, p. 121. 13. Wolff, E.,8 p. 290. 14. Coston, T. O.: Personal communication to the author. 15. Bettman, J. W., and Fellows, V.: Factors Influencing the Blood Volume of the Choroid and Retina , Amer. J. Ophthal. 46:1 (July, (Pt. 1) ) 1958. 16. Michaelson, I. C.: Retinal Artery Occlusion , Brit. J. Ophthal. 32:111, 1948.Crossref 17. Trowbridge, W. V.; Bayless, A. E., and French, J. D.: Stellate Block: Technique, Dangers and Safeguards , Neurology (Minneap.) 2:529, 1952.Crossref 18. Moore, D. C.: Regional Block , Springfield, Ill., Charles C Thomas, Publisher, 1957, pp. 106-112. 19. Walsh, R. C.: Stellate Ganglion Block in General Practice , Brit. Med. J. 2:684, 1954.Crossref 20. Moore, D. C., and Bridenbaugh, L. D.: The Anterior Approach to the Stellate Ganglion: Use Without a Serious Complication in 2,000 Blocks , J.A.M.A. 160:158, 1956.Crossref 21. Brinkhous, K. M., and Roberts, H. R.: Thrombolysis and Thrombolytic Agents , J.A.M.A. 175:284, 1961.Crossref 22. Lindeke, H. I., and Masler, S. R.: Therapy of Retinal Vein Occlusion: Use of Fibrinolysin and Anticoagulants , Amer. J. Ophthal. 51:456, 1961. 23. Leahey, B. D.: Personal communication to the author. 24. Hancock, W. I.: Certain Points in Regard to Fields and Fundus Changes in Obstruction of the Central Artery of the Retina , Roy. Lond. Ophthal. Hosp. Rep. 17:428, 1908. 25. Verhoeff, F. H.: discussion of Reference 1. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Idiopathic Central Retinal Artery Occlusion: Case Report and Presentation of a General Guide to Therapy

HARDENBERGH, FIRMON E
Archives of Ophthalmology , Volume 67 (5) – May 1, 1962
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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1962.00960020556006
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Abstract

Abstract The purpose of this paper is to report an unusual case of idiopathic central retinal artery occlusion in a young man who experienced remarkable recovery of vision and to present a comprehensive therapeutic approach to this clinical entity. Report of Case A 20-year-old Caucasian male, always in good general health, with no previous ocular or neurologic symptoms, experienced sudden loss of vision in the right eye while calmly walking.When first examined approximately 80 minutes later, the patient had no light perception in the right eye except in the temporal periphery where he could detect finger motions. He presented the classical picture of central retinal artery occlusion, including a cherry-red macula with surrounding intense edema. There was apparent stasis in all arterioles. The veins were smaller than those of the left eye, and there was intermittent tumbling of red cell clumps into the physiologic cup as if they were being References 1. Admission height and weight were 69 inches and 225 pounds, respectively. 2. Transient faint pulsations may be observed even in total obstruction as the blood compressed in the vessel distal to the obstruction is advanced by the pulse pressure transmitted through the obstruction. This may be less transient the more proximal the site of the obstruction. 3. Such as acetylcholine, aminophylline, papaverine, tolazoline or nicotinic acid. 4. This temporal island is to be distinguished from the frequently found islands of eccentric tubular field corresponding to small areas of peri-papillary retina whose function is attributed to vascular supply via small branches from the arterial circle of Zinn. 5. de Schweinitz, G. E., and Holloway, T. B.: Sudden Obstruction of the Central Artery of the Retina , Trans. Amer. Ophthal. Soc. 11:471, 1908. 6. Coverdale, H. V.: The Cause and Results of Obstruction of the Central Artery of the Retina , Brit. J. Ophthal. 13:529, 1929.Crossref 7. Werner, L.: On Vascular and Other Retinal Changes Associated with General Disease , Trans. Ophthal. Soc. U.K. 33:9, 1913. 8. Werner, L.: Bilateral Obstruction of the Central Artery of the Retina , Trans. Ophthal. Soc. U.K. 51:654, 1931. 9. Guillette, J. L., and Mayer, W.: Thrombosis of the Central Retinal Artery , Amer. J. Ophthal. 37:578, 1954. 10. Knapp, A.: Embolism of a Branch of the Retinal Artery with Hemorrhagic Infarctus in the Retina , Arch. Ophthal. 1:64, 1869. 11. Coston, T. O.: Ocular Symptoms of Stellate Ganglion Block: Its Use in the Treatment of Occlusion of the Central Retinal Artery , Amer. J. Ophthal. 34:1289, 1951. 12. Wolff, E.: The Anatomy of the Eye and Orbit , Fourth Edition, New York, Blakiston Co., Division of McGraw-Hill Book Co., Inc., 1955, p. 121. 13. Wolff, E.,8 p. 290. 14. Coston, T. O.: Personal communication to the author. 15. Bettman, J. W., and Fellows, V.: Factors Influencing the Blood Volume of the Choroid and Retina , Amer. J. Ophthal. 46:1 (July, (Pt. 1) ) 1958. 16. Michaelson, I. C.: Retinal Artery Occlusion , Brit. J. Ophthal. 32:111, 1948.Crossref 17. Trowbridge, W. V.; Bayless, A. E., and French, J. D.: Stellate Block: Technique, Dangers and Safeguards , Neurology (Minneap.) 2:529, 1952.Crossref 18. Moore, D. C.: Regional Block , Springfield, Ill., Charles C Thomas, Publisher, 1957, pp. 106-112. 19. Walsh, R. C.: Stellate Ganglion Block in General Practice , Brit. Med. J. 2:684, 1954.Crossref 20. Moore, D. C., and Bridenbaugh, L. D.: The Anterior Approach to the Stellate Ganglion: Use Without a Serious Complication in 2,000 Blocks , J.A.M.A. 160:158, 1956.Crossref 21. Brinkhous, K. M., and Roberts, H. R.: Thrombolysis and Thrombolytic Agents , J.A.M.A. 175:284, 1961.Crossref 22. Lindeke, H. I., and Masler, S. R.: Therapy of Retinal Vein Occlusion: Use of Fibrinolysin and Anticoagulants , Amer. J. Ophthal. 51:456, 1961. 23. Leahey, B. D.: Personal communication to the author. 24. Hancock, W. I.: Certain Points in Regard to Fields and Fundus Changes in Obstruction of the Central Artery of the Retina , Roy. Lond. Ophthal. Hosp. Rep. 17:428, 1908. 25. Verhoeff, F. H.: discussion of Reference 1.

Journal

Archives of Ophthalmology – American Medical Association

Published: May 1, 1962

References

  • Sudden Obstruction of the Central Artery of the Retina
    de Schweinitz , G. E., and Holloway, T. B.
  • The Cause and Results of Obstruction of the Central Artery of the Retina
    Coverdale , H. V.
  • On Vascular and Other Retinal Changes Associated with General Disease
    Werner , L.
  • Bilateral Obstruction of the Central Artery of the Retina
    Werner , L.
  • Thrombosis of the Central Retinal Artery
    Guillette , J. L., and Mayer, W.
  • Embolism of a Branch of the Retinal Artery with Hemorrhagic Infarctus in the Retina
    Knapp , A.
  • Ocular Symptoms of Stellate Ganglion Block: Its Use in the Treatment of Occlusion of the Central Retinal Artery
    Coston , T. O.
  • The Anatomy of the Eye and Orbit
    Wolff , E.
  • Factors Influencing the Blood Volume of the Choroid and Retina
    Bettman , J. W., and Fellows, V.
  • Retinal Artery Occlusion
    Michaelson , I. C.
  • Stellate Block: Technique, Dangers and Safeguards
    Trowbridge , W. V.; Bayless, A. E., and French, J. D.
  • Regional Block
    Moore , D. C.
  • Stellate Ganglion Block in General Practice
    Walsh , R. C.
  • The Anterior Approach to the Stellate Ganglion: Use Without a Serious Complication in 2,000 Blocks
    Moore , D. C., and Bridenbaugh, L. D.
  • Thrombolysis and Thrombolytic Agents
    Brinkhous , K. M., and Roberts, H. R.
  • Therapy of Retinal Vein Occlusion: Use of Fibrinolysin and Anticoagulants
    Lindeke , H. I., and Masler, S. R.
  • Certain Points in Regard to Fields and Fundus Changes in Obstruction of the Central Artery of the Retina
    Hancock , W. I.