Jost B Jonas1, Antje Niessen. 1. Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
Abstract
PURPOSE: To describe a patient presenting with typical signs of vascular occlusive retinopathy. DESIGN: Observational case report. METHODS: A 65-year-old man experienced painless unilateral loss of vision to 4/20 in his left eye. Ophthalmoscopy of the left eye showed pronounced attenuation of the retinal arterioles, ischemic retinal edema, and a few intraretinal hemorrhages. Fluorescein angiography revealed a diffusely reduced retinal perfusion typical of retinal occlusive disease. Using a new ophthalmodynamometer with a pressure sensor at the mounting support of a conventional Goldmann contact lens, we additionally measured the diastolic central retinal artery collapse pressure. RESULTS: The diastolic central retinal artery collapse pressure was significantly lower in the left eye than in the right eye (14.7 +/- 2.4 relative units vs 51.7 +/- 4.3 relative units; P <.001). Both values were significantly (P =.03) lower than those in a control group (80.9 +/- 6.9 relative units). Doppler sonography revealed a total occlusion of the left carotid artery and a nonrelevant stenosis of the right carotid artery. CONCLUSIONS: A new ophthalmodynamometric device consisting of a pressure sensor at the mounting support of a Goldmann contact lens was helpful in detecting carotid artery occlusion leading to ischemic ophthalmopathy.
PURPOSE: To describe a patient presenting with typical signs of vascular occlusive retinopathy. DESIGN: Observational case report. METHODS: A 65-year-old man experienced painless unilateral loss of vision to 4/20 in his left eye. Ophthalmoscopy of the left eye showed pronounced attenuation of the retinal arterioles, ischemic retinal edema, and a few intraretinal hemorrhages. Fluorescein angiography revealed a diffusely reduced retinal perfusion typical of retinal occlusive disease. Using a new ophthalmodynamometer with a pressure sensor at the mounting support of a conventional Goldmann contact lens, we additionally measured the diastolic central retinal artery collapse pressure. RESULTS: The diastolic central retinal artery collapse pressure was significantly lower in the left eye than in the right eye (14.7 +/- 2.4 relative units vs 51.7 +/- 4.3 relative units; P <.001). Both values were significantly (P =.03) lower than those in a control group (80.9 +/- 6.9 relative units). Doppler sonography revealed a total occlusion of the left carotid artery and a nonrelevant stenosis of the right carotid artery. CONCLUSIONS: A new ophthalmodynamometric device consisting of a pressure sensor at the mounting support of a Goldmann contact lens was helpful in detecting carotid artery occlusion leading to ischemic ophthalmopathy.