Document Detail

Echocardiographic findings of patients with retinal ischemia or embolism.
MedLine Citation:
PMID:  12116739     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: A potential source of emboli is not detected in more than 50% of patients with retinal arterial occlusive events. Echocardiographic studies are not always included in the diagnostic workup of these patients. The authors studied the diagnostic yield of transthoracic (TTE) and/or transesophageal (TEE) echocardiography in identifying potential sources of emboli in patients with retinal ischemia or embolism. METHODS: In a prospective study, 73 consecutive patients with clinically diagnosed retinal ischemia or embolism received a standardized diagnostic workup including retinal photography, echocardiography, and imaging studies of the internal carotid arteries. TTE was performed in 83.6% of patients, TEE was performed in 5.5% of patients, and both TTE and TEE were performed in 11.0% of patients. Ophthalmological diagnoses consisted of amaurosis fugax (n = 28), asymptomatic cholesterol embolism to the retina (n = 34), and branch or central retinal artery occlusion (n = 11). RESULTS: Echocardiography identified a potential cardiac or proximal aortic source for embolism in 16 of 73 (21.9%) patients, including 8 who also had either atrial fibrillation or internal carotid artery stenosis of more than 50% on the side of interest. Thus, 8 of 73 (11.0%) patients had lesions detected only by echocardiography. The most commonly identified lesions were proximal aortic plaque of more than 4 mm thickness (n = 7, 9.6%) and left ventricular ejection fraction of less than 30% (n = 6, 8.2%). TEE was particularly helpful in identifying prominent aortic plaques. CONCLUSION: Echocardiography frequently identifies lesions of the heart or aortic arch that can act as potential sources for retinal ischemia or embolism. Further studies are needed to evaluate the prognostic and therapeutic relevance of these findings.
Mikael Mouradian; Christine A C Wijman; Douglas Tomasian; Ravin Davidoff; Behrooz Koleini; Viken L Babikian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  12     ISSN:  1051-2284     ISO Abbreviation:  J Neuroimaging     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-15     Completed Date:  2002-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-23     Citation Subset:  IM    
Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
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MeSH Terms
Amaurosis Fugax / ultrasonography
Echocardiography, Transesophageal*
Embolism, Cholesterol / etiology,  ultrasonography*
Prospective Studies
Retinal Artery Occlusion / complications,  ultrasonography*

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