J Korean Ophthalmol Soc.  2022 Apr;63(4):406-411. 10.3341/jkos.2022.63.4.406.

Transient Total Occlusive Attack of the Ophthalmic Artery with Asymptomatic Patent Foramen Ovale

• Choi HG
• Park D
• Choi YJ
• Park SP

• KMID: 2528334
• DOI: http://doi.org/10.3341/jkos.2022.63.4.406

Abstract

Purpose
To report a case of transient total occlusive attack of the ophthalmic artery with asymptomatic patent foramen ovale.
Case summary
A 31‐year‐old female presented with worsening of intermittent visual loss in her right eye from the previous day. The visual acuity in the right eye was reduced to 0.04 at her first visual examination. In the doctor’s room, her visual acuity in the right eye improved to 1.0 at first; however, after several minutes, it decreased to no light perception. A relative afferent pupillary defect was observed. Following that, fluorescein angiography was performed, and visual acuity improved and worsened repeatedly; corresponding intermittent perfusion and occlusion of the ophthalmic artery were observed during the examination. Further evaluation was performed to determine the cause of intermittent occlusion of the ophthalmic artery; patent foramen ovale was diagnosed. Transient ophthalmic artery occlusion was presumed to have occurred owing to embolism by the patent foramen ovale. Aspirin was used as a prophylaxis. Since then, there have been no recurring symptoms of visual impairment.
Conclusions
Patients with ophthalmic diseases such as ophthalmic artery occlusion, retinal artery occlusion, and amaurosis fugax, especially young people, require a thorough assessment to identify potential causes of embolism.

Keyword

Amaurosis fugax, Ophthalmic artery, Patent foramen ovale, Retinal artery occlusion