Korean J Ophthalmol.  1999 Jun;13(1):36-42. 10.3341/kjo.1999.13.1.36.

Continued lodging of retinal emboli in a patient with internal carotid artery and ophthalmic artery occlusions

• Kim IT
• Park SK
• Shim SD

• KMID: 1081834
• DOI: http://doi.org/10.3341/kjo.1999.13.1.36

Abstract

Internal carotid artery or ophthalmic artery occlusions are devastating ophthalmological events which lead to severe impairment of vision. A case of multiple branch retinal artery occlusions in a 63-year-old male with internal carotid artery and ophthalmic artery occlusions on brain angiography is presented. Emboli lodging in branches of the retinal arteries were bright, glistening, yellow or orange in appearance. Such a distinctive ophthalmoscopic appearance led to the diagnosis of cholesterol emboli. Fluorescein and indocyanine green angiography disclosed delayed filling of the retinal vessels and choroid, and showed multiple hypofluorescence distal to the vessels in which the emboli were lodged. At the time of initial examination, the number of emboli lodged in retinal arteries was estimated at more than 20. As time passed, a few of the previous emboli disappeared and new emboli appeared in other sites on fundus examination. We think that the lodging of new emboli in other sites is due to the continued break-up of atheromatous tissue through the collateral circulation associated with the occlusion of the internal carotid and ophthalmic arteries.

Keyword

Fluorescein angiography; Indocyanine green angiography; Internal carotid artery occlusion; Ophthalmic artery occlusion; Retinal emboli

MeSH Terms

Acute Disease
Arterial Occlusive Diseases/radiography
Arterial Occlusive Diseases/complications*
Carotid Artery, Internal*
Carotid Stenosis/radiography
Carotid Stenosis/complications
Case Report
Cerebral Angiography
Fluorescein Angiography
Fundus Oculi
Human
Male
Middle Age
Ophthalmic Artery*
Retinal Artery Occlusion/etiology*
Retinal Artery Occlusion/diagnosis
Thromboembolism/etiology*
Thromboembolism/diagnosis
Visual Acuity