Valérie Biousse1, Jonathan D Trobe. 1. Neuro-ophthalmology Unit, Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia 30322, USA. vbiouss@emory.edu
Abstract
PURPOSE: To provide a practical update on the diagnosis and management of transient monocular visual loss (TMVL). DESIGN: Perspective. METHODS: Review of the literature. RESULTS: TMVL is an important clinical symptom. It has numerous causes but most often results from transient retinal ischemia. It may herald permanent visual loss or a devastating stroke, and patients with TMVL should be evaluated urgently. A practical approach to the evaluation of the patient with TMVL must be based on the patient's age and the suspected underlying etiology. In the older patient, tests should be performed to investigate giant cell arteritis, atherosclerotic large vessel disease, and cardiac abnormalities. In the younger patient, TMVL is usually benign and the evaluation should be tailored to the particular clinical setting. CONCLUSIONS: Specific prevention strategies are tailored to the most likely cause of TMVL and the patient's underlying risk factors. Prevention of a future event should begin in the ophthalmologist's office with education and aggressive treatment of artherosclerotic risk factors.
PURPOSE: To provide a practical update on the diagnosis and management of transient monocular visual loss (TMVL). DESIGN: Perspective. METHODS: Review of the literature. RESULTS: TMVL is an important clinical symptom. It has numerous causes but most often results from transient retinal ischemia. It may herald permanent visual loss or a devastating stroke, and patients with TMVL should be evaluated urgently. A practical approach to the evaluation of the patient with TMVL must be based on the patient's age and the suspected underlying etiology. In the older patient, tests should be performed to investigate giant cell arteritis, atherosclerotic large vessel disease, and cardiac abnormalities. In the younger patient, TMVL is usually benign and the evaluation should be tailored to the particular clinical setting. CONCLUSIONS: Specific prevention strategies are tailored to the most likely cause of TMVL and the patient's underlying risk factors. Prevention of a future event should begin in the ophthalmologist's office with education and aggressive treatment of artherosclerotic risk factors.
Authors: Johanna Helenius; E Murat Arsava; Joshua N Goldstein; Dean M Cestari; Ferdinando S Buonanno; Bruce R Rosen; Hakan Ay Journal: Ann Neurol Date: 2012-08 Impact factor: 10.422