Abstract The classic ophthalmoscopic picture of total central retinal artery occlusion is well known, as is the histopathologic picture of old postocclusive change in the retina and optic nerve. The etiology of central retinal artery occlusion is varied, and is thought to include such diverse mechanisms as atheroma formation,1 emboli of atheromatous2 and non-atheromatous nature,3 spasm of the central retinal artery, dissecting aneurysm,4 migraine,5 and foreign body obstruction.6 The purpose of this paper is to report a case of central retinal artery occlusion in which the patient died 68 hours following his occlusion. Both eyes were subsequently studied histologically. Because postocclusive scarring had not had time to develop, the mechanism by which arterial occlusion had occurred could readily be seen. The associated retinal changes are also reported. Report of Case The patient, a 49-year-old white male physician with a long history of moderate hypertension with References 1. Monoamine oxidase inhibitors, a group of potent antidepressant drugs that act by blocking the enzymatic degradation of such natural excitatory substances as norepinephrine and serotonin, have recently come under investigation by the Food and Drug Administration because of reports from both Europe and the United States of hypertensive crises occurring during their use.7-9 These crises, in some cases, have been linked to the concurrent ingestion of cheese, beer, or wine.10-12 2. Verhoeff, F. H.: Obstruction of Central Retinal Vein , Arch Ophthal 36:1-36, 1907. 3. Russell, R. W. R.: Atheromatous Retinal Embolism , Lancet 2:1,354-1,356, 1963.Crossref 4. Manschot, W. A.: Embolism of Central Retinal Artery Originating From an Endocardial Myxoma , Amer J Ophthal 48:381-385, 1959. 5. Garron, L. K.: Dissecting Aneurysm of Central Retinal Artery. Preliminary Report , Trans Pacif Coast Otoophthal Soc 33:157-171, 1952. 6. Krapin, D.: Occlusion of Central Retinal Artery in Migraine , New Eng J Med 270:359-360, 1964.Crossref 7. Appelmans, M.; Michiels, J.; and Beka, A.: Obstruction of Central Artery of Retina by Metallic Foreign Body , Bull Soc Belg Ophthal 126:1,074-1,082, 1961. 8. Dorrell, W.: Tranylcypromine and Intracranial Bleeding , Lancet 2:300, 1963.Crossref 9. McClure, J. L.: Reactions Associated With Tranylcypromine , Lancet 1:1,351, 1962.Crossref 10. Paradoxical Hypertension From Tranylcypromine Sulfate , JAMA Council on Drugs, JAMA 186:854, 1963. 11. Davies, E. B.: Tranylcypromine and Cheese , Lancet 2:691-692, 1963.Crossref 12. Horwitz, D., et al: Monoamine Oxidase Inhibitors, Tyramine, and Cheese , JAMA 188:1,108-1,110, 1964.Crossref 13. Blackwell, B.: Hypertensive Crisis Due to Monoamine-Oxidase Inhibitors , Lancet 2:849-856, 1963.Crossref 14. Leffertstra, L. J.: Results of Early Treatment in Case of Spasm of the Central Retinal Artery , Ophthalmologica 144:433-437, 1962.Crossref 15. Hecker, S. P., and Zweng, H. C.: Central Retinal Artery Occlusion Successfully Treated with Plasmin , JAMA 176:1067-1069, 1961.Crossref 16. Simmonds, N. T.: Embolus of Central Retinal Artery, Successfully Treated by Paracentesis , Amer J Ophthal 54:1129-1130, 1962. 17. Hogan, M. J., and Zimmerman, L. E.: Ophthalmic Pathology, An Atlas and Textbook , ed 2, Philadelphia: W. B. Saunders Co., 1962. 18. Reinecke, R. D., et al: Retinal Vascular Patterns. Part V: Experimental Ischemia of Cat Eye , Arch Ophthal 67:470-475, 1962.Crossref
Archives of Ophthalmology – American Medical Association
Published: Apr 1, 1965
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