Sectoral Sparing Associated With a Cilioretinal Artery in Arteritic Anterior Ischemic Optic Neuropathy.
Journal
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
ISSN: 1536-5166
Titre abrégé: J Neuroophthalmol
Pays: United States
ID NLM: 9431308
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
pubmed:
4
12
2021
medline:
25
5
2022
entrez:
3
12
2021
Statut:
ppublish
Résumé
Giant cell arteritis (GCA) is a life-threatening vasculitis occurring in older adults that can cause blindness by ischemia of the choroid, retina, and optic nerve. We report a case of a patient who presented with "occult" GCA with severe anterior ischemic optic neuropathy affecting both optic nerves, delayed choroidal filling, and a concomitant cilioretinal artery occlusion in the left eye. The retinal territory supplied by the affected cilioretinal artery was hypoperfused, yet this retinal territory at least partially corresponded to the only preserved visual field in that eye. The sector of the optic disc corresponding to the emergence of the cilioretinal artery was the only sector spared by pallid edema. This pattern of sectoral sparing associated with a cilioretinal artery has been observed in other patients with GCA and in animal models of posterior ciliary artery occlusion. This case serves as a clear example of an incompletely understood phenomenon in posterior pole circulation in vascular occlusive disease that deserves further study.
Identifiants
pubmed: 34860740
doi: 10.1097/WNO.0000000000001418
pii: 00041327-202206000-00043
pmc: PMC10311077
mid: NIHMS1908837
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e514-e516Subventions
Organisme : NEI NIH HHS
ID : K08 EY030164
Pays : United States
Informations de copyright
Copyright © 2021 by North American Neuro-Ophthalmology Society.
Déclaration de conflit d'intérêts
E. D. Gaier: Luminopia, Inc (scientific advisor, equity, patent). Stoke Therapeutics, Inc (consultant). J. F. Rizzo: Magic Leap (medical director). The remaining author report no conflicts of interest.
Références
Mack HG, O'Day J, Currie JN. Delayed choroidal perfusion in giant cell arteritis. J Clin Neuroophthalmol. 1991;11:221–227.
Siatkowski RM, Gass JD, Glaser JS, Smith JL, Schatz NJ, Schiffman J. Fluorescein angiography in the diagnosis of giant cell arteritis. Am J Ophthalmol. 1993;115:57–63.
Hayreh SS, Baines JA. Occlusion of the posterior ciliary artery. I. Effects on choroidal circulation. Br J Ophthalmol. 1972;56:719–735.
Hayreh SS, Baines JA. Occlusion of the posterior ciliary artery. II. Chorio-retinal lesions. Br J Ophthalmol. 1972;56:736–753.
Quillen DA, Cantore WA, Schwartz SR, Brod RD, Sassani JW. Choroidal nonperfusion in giant cell arteritis. Am J Ophthalmol. 1993;116:171–175.
Justice J Jr, Lehmann RP. Cilioretinal arteries. A study based on review of stereo fundus photographs and fluorescein angiographic findings. Arch Ophthalmol. 1976;94:1355–1358.
Hayreh SS. The cilio-retinal arteries. Br J Ophthalmol. 1963;47:71–89.
Hayreh SS. Anterior ischaemic optic neuropathy. Differentiation of arteritic from non-arteritic type and its management. Eye (Lond). 1990;4:25–41.
Hayreh SS, Podhajsky PA, Zimmerman B. Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998;125:509–520.
Akash R, Hrishikesh D, Amith P, Sabah S. Case report: association of combined nonarteritic anterior ischemic optic neuropathy (NAION) and obstruction of cilioretinal artery with overdose of Viagra. J Ocul Pharmacol Ther. 2005;21:315–317.
Hayreh SS, Baines JA. Occlusion of the posterior ciliary artery. 3. Effects on the optic nerve head. Br J Ophthalmol. 1972;56:754–764.
Galasso JM, Jay WM. An occult case of giant cell arteritis presenting with combined anterior ischemic optic neuropathy and cilioretinal artery occlusion. Semin Ophthalmol. 2004;19:75–77.
McLeod D. Central retinal vein occlusion with cilioretinal infarction from branch flow exclusion and choroidal arterial steal. Retina. 2009;29:1381–1395.
Rizzo JF III. Unraveling the enigma of nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol. 2019;39:529–544.