-
Stroke Feb 1990We present a consensus on the pathophysiology, etiology, diagnosis, and treatment of amaurosis fugax. The phenomenon is defined and described, and the roles that... (Review)
Review
We present a consensus on the pathophysiology, etiology, diagnosis, and treatment of amaurosis fugax. The phenomenon is defined and described, and the roles that extracranial and ocular vascular diseases play are discussed. Nonvascular ophthalmic and neurologic disorders that can be confused with amaurosis fugax are listed, and an algorithm for evaluation (which includes ophthalmic examination, laboratory studies, and noninvasive carotid artery studies) is given. Treatment of atherosclerosis, carotid artery disease, and other causes of amaurosis fugax are also discussed.
Topics: Aspirin; Blindness; Carotid Arteries; Carotid Artery Diseases; Cerebrovascular Disorders; Constriction, Pathologic; Diagnosis, Differential; Endarterectomy; Humans; Terminology as Topic; Vision, Monocular
PubMed: 2406992
DOI: 10.1161/01.str.21.2.201 -
Cureus Jun 2022There are many causes of amaurosis fugax, including polycythemia. Polycythemia is associated with elevated hematocrit levels and hyperviscosity, which can lead to ocular...
There are many causes of amaurosis fugax, including polycythemia. Polycythemia is associated with elevated hematocrit levels and hyperviscosity, which can lead to ocular manifestations. We report a polycythemia patient with amaurosis fugax, who had resolution of ocular symptoms following venesection. A 29-year-old gentleman presented with a six-month history of episodic bilateral transient loss of vision (amaurosis fugax), followed by slow recovery back to normal after 15-20 minutes. The symptoms worsened with fatigue. He also had an unsteady gait for the preceding one year. Ocular examination was unremarkable. His visual acuity was 20/20 OU. Neurological examination revealed gait ataxia and dysdiadochokinesia. Computed tomography (CT) angiogram showed an old cerebellar infarct. Blood investigations showed persistent elevated hemoglobin and hematocrit with positive JAK-2 V617F mutation. Infective and connective tissue workups were all negative. A diagnosis of polycythemia was made by the haematology team. In addition to oral aspirin given by the neurology team, he underwent venesection with improvement in ocular symptoms following each episode of venesection. The frequency of amaurosis fugax reduced from 2-3 episodes a week to once a month, then resolved completely after five venesections. Systemically, his cerebellar symptoms also resolved and there were no neurological deficits. Polycythemia is a rare disease that can cause amaurosis fugax and thrombotic events in young patients. Better knowledge and accurate diagnosis are important, as early treatment may improve the symptoms and long-term morbidity.
PubMed: 35812629
DOI: 10.7759/cureus.25752 -
Journal of Vascular Surgery Nov 2011Amaurosis fugax is a manifestation of retinal ischemia, commonly described in the setting of carotid atherosclerotic disease. Thromboembolic, and less frequently,...
Amaurosis fugax is a manifestation of retinal ischemia, commonly described in the setting of carotid atherosclerotic disease. Thromboembolic, and less frequently, hemodynamic mechanisms have been described as responsible for producing negative symptoms of transient monocular vision loss during periods of wakefulness. We report an unusual presentation in which the patient became symptomatic during sleep. Initially, photopsias-positive symptoms were experienced, which caused the patient to awaken; this was immediately followed by transient monocular vision loss. Carotid endarterectomy was curative.
Topics: Aged, 80 and over; Amaurosis Fugax; Carotid Stenosis; Endarterectomy, Carotid; Female; Hemodynamics; Humans; Sleep; Treatment Outcome; Ultrasonography
PubMed: 21723066
DOI: 10.1016/j.jvs.2011.04.059 -
Archives of Ophthalmology (Chicago,... Nov 1999
Topics: Amaurosis Fugax; Female; Humans; Hypertension; Middle Aged; Pupil Disorders; Retinal Diseases; Retinal Vein; Vasospasm, Intracranial; Visual Acuity
PubMed: 10565534
DOI: 10.1001/archopht.117.11.1568 -
Journal of Neuro-ophthalmology : the... Dec 2023
Topics: Humans; Amaurosis Fugax; Constriction, Pathologic; Posterior Cerebral Artery; Carotid Artery, Internal; Carotid Stenosis; Cerebrovascular Disorders; Blindness
PubMed: 35439227
DOI: 10.1097/WNO.0000000000001566 -
Journal of Neurology, Neurosurgery, and... Feb 2003
Topics: Amaurosis Fugax; Calcium Channel Blockers; Cyclandelate; Diagnosis, Differential; Humans; Laser-Doppler Flowmetry; Male; Middle Aged; Retinal Artery Occlusion; Vasoconstriction
PubMed: 12531936
DOI: 10.1136/jnnp.74.2.149 -
Stroke 1975Amaurosis fugax (transient monocular blindness) is a symptom of retinal ischemia just as contralateral hemiparesis and sensory loss are symptoms of cerebral ischemia....
Amaurosis fugax (transient monocular blindness) is a symptom of retinal ischemia just as contralateral hemiparesis and sensory loss are symptoms of cerebral ischemia. These symptoms are produced by atherosclerotic stenosis of the carotid vessels at the ipsilateral carotid bifurcation and emboli from these areas causing focal, repetitive, retinal ischemia. A study of 31 endarterectomy patients was undertaken to see if eight patients with amaurosis fugax (25%) could be differentiated from 22 patients with transient cerebral ischemia. The patients with amaurosis fugax were found to be younger. They all had 75% or greater stenosis of the internal carotid artery at the bifurcation on the symptomatic side. They all had unilateral visual symptoms and these symptoms were relieved by surgery. The patients with amaurosis fugax were devoid of cardiac disease, while 45% of the cerebral ischemic patients had documented myocardial disease. Amaurosis fugax (transient monocular blindness) in the setting of clinically significant atheroslerosis of the carotid vessels is an indication for carotid endarterectomy.
Topics: Blindness; Carotid Artery Diseases; Carotid Artery, Internal; Constriction, Pathologic; Diagnosis, Differential; Embolism; Female; Humans; Intracranial Arteriosclerosis; Ischemia; Ischemic Attack, Transient; Male; Middle Aged; Retinal Vessels
PubMed: 1179455
DOI: 10.1161/01.str.6.5.493 -
Neurology Dec 1987
Topics: Blindness; Female; Humans; Middle Aged; Thrombocythemia, Essential
PubMed: 3683889
DOI: 10.1212/wnl.37.12.1888-b -
Canadian Journal of Ophthalmology.... Jun 2019
Topics: Adenocarcinoma of Lung; Aged, 80 and over; Amaurosis Fugax; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Female; Humans; Lung Neoplasms; Neoplasm Metastasis; Positron Emission Tomography Computed Tomography
PubMed: 31109501
DOI: 10.1016/j.jcjo.2018.08.012 -
Rheumatology International Mar 2023Visual disturbances in Takayasu arteritis (TA) are common but tend to be late manifestations of the disease. However, its presence at diagnosis must alert TA to avoid... (Review)
Review
Visual disturbances in Takayasu arteritis (TA) are common but tend to be late manifestations of the disease. However, its presence at diagnosis must alert TA to avoid sight disabilities. Herein, we present two children with TA that debuted with vision loss, and the results of the literature review displayed 58 subjects with vision loss before the diagnosis of TA. The world English literature was reviewed by searching the PubMed database of the National Library of Medicine for the terms "Takayasu Arteritis" and "Blindness" or "Amaurosis fugax", from 190 to 2021. Cases eligible must present vision loss before or at TA diagnosis. Our two patients who presented with amaurosis fulfilled the criteria for TA diagnosis. The first patient had a bilateral and transient visual loss, whereas the second had monocular and permanent amaurosis. Both patients were cursed with hypertension and demonstrated large vessel compromise; their clinical picture improved with corticosteroids and immunosuppressant therapy. We identified in the literature review sixteen patients with TA in case reports and 42 in case series, plus our two cases presented herein with monocular or bilateral vision loss at the time of diagnosis. Previous literature indicated that amaurosis represents a severely advanced disease. Herein, we reported two children with amaurosis as their pivotal symptom; they had significant head and neck vascular alterations, so prompt and aggressive treatment is needed to prevent disease progression and disability. Transient or permanent vision loss must alert the physician to include Takayasu arteritis in the differential diagnosis.
Topics: United States; Humans; Child; Immunosuppression Therapy; Blindness; Disease Progression; Takayasu Arteritis; Diagnosis, Differential
PubMed: 35366089
DOI: 10.1007/s00296-022-05115-2