MyMedR

Primary cardiac valve tumours are rare. This is a case report of a 32-year-old non-smoker man with a history of stroke 1 year prior and no other cardiovascular risk factors. The patient was admitted to our acute stroke ward for recurrent left hemiparesis, slurring of speech, facial asymmetry and central retinal artery occlusion. Initial laboratory investigations and ECG were normal. An urgent CT brain showed a large hypodense area at the right frontal, parietal, temporal, occipital region with effaced sulci and right lateral ventricle with midline shift and cerebral oedema in keeping with acute infarction. We proceeded with CT angiography of the cerebral and carotid on the following day, which revealed no evidence of thrombosis, aneurysm or arteriovenous malformation. There were no abnormal beaded vessels to suggest vasculitis. Transthoracic echocardiography revealed a large mobile mass in the left atrium. Meanwhile, MRI cardiac confirmed a large ill-defined mobile solid mass attached to the mitral valve's inferoseptal component suggestive of mitral valve myxoma. This case report highlights the significance of considering a cardiogenic source of emboli in patients with large cerebral infarcts and other cardiac embolic phenomena. Imaging modalities such as echocardiography and cardiac MRI will help detect treatable conditions, such as valvular myxoma and prevent further complications.

Matched MeSH terms: Retinal Artery Occlusion/diagnosis; Retinal Artery Occlusion/etiology*

Fulltext Unilateral rhino-orbital-cerebral mucormycosis with contralateral endogenous fungal endophthalmitis

Ho HC, Liew OH, Teh SS, Hanizasurana H, Ibrahim M, Shatriah I

Clin Ophthalmol, 2015;9:553-6.

PMID: 25848206 DOI: 10.2147/OPTH.S82204

Rhino-orbital-cerebral mucormycosis (ROCM) is an uncommon but fatal fungal infection. We report a rare case of unilateral ROCM with ipsilateral central retinal artery occlusion and contralateral choroiditis, which later progressed to endogenous fungal endophthalmitis. The patient was successfully treated with sinuses debridement, systemic liposomal amphotericin B, and intravitreal amphotericin B. The endophthalmitis completely resolved with good vision, but the ROCM eye remained blind due to central retinal artery occlusion.

Matched MeSH terms: Retinal Artery Occlusion

Fulltext Central Retinal Artery Occlusion with Sparing of Cilioretinal Artery Post Pulmonary Artery Stenting

Oo KT, Mohd-Zain MR, Shatriah I

Cureus, 2018 Jan 29;10(1):e2128.

PMID: 29607276 DOI: 10.7759/cureus.2128

Central retinal arterial occlusion is an ocular emergency. Central retinal artery occlusion following cardiac procedures have been described in adults. We describe a pediatric patient who developed central retinal artery occlusion following pulmonary artery stenting. It is important to highlight this potential risk to ensure early diagnosis and prompt treatment.

Matched MeSH terms: Retinal Artery Occlusion

Fulltext Herpes Zoster Ophthalmicus, Central Retinal Artery Occlusion, and Neovascular Glaucoma in an Immunocompetent Individual

Ahmad SS, Suan ALL, Alexander SM

J Ophthalmic Vis Res, 2019 3 2;14(1):97-100.

PMID: 30820294 DOI: 10.4103/jovr.jovr_65_17

Purpose: To report the unusual case of an immunocompetent individual with herpes zoster ophthalmicus who developed central retinal artery occlusion and subsequent neovascular glaucoma.

Case Report: A 40-year-old, immunocompetent patient was diagnosed with herpes zoster ophthalmicus and central retinal artery occlusion on initial presentation. Subsequently, he developed neovascular glaucoma.

Conclusion: There are a few case reports of central retinal artery occlusion developing after varicella zoster virus infection. However, a literature search found no reports of neovascular glaucoma following central retinal artery occlusion secondary to varicella zoster virus infection. The present case report indicates that neovascular glaucoma is a possible complication in such a scenario.

Matched MeSH terms: Retinal Artery Occlusion

Fulltext Unilateral visual loss after spine surgery in the prone position for extradural haematoma in a healthy young man

Ooi EI, Ahem A, Zahidin AZ, Bastion ML

BMJ Case Rep, 2013;2013.

PMID: 24334521 DOI: 10.1136/bcr-2013-200632

This case reports a patient who developed central retinal artery occlusion following spinal surgery in the prone position. When placed in this position, especially as a result of malposition of the head, the patient may develop external compression of the eye which leads to central retinal artery occlusion. Therefore, a special precaution must be given for adequate eye protection during prolonged prone-positioned spine surgery.

Matched MeSH terms: Retinal Artery Occlusion/etiology*

Fulltext Central retinal artery occlusion and ophthalmoplegia following spinal surgery in the prone position

Asok T, Aziz S, Faisal HA, Tan AK, Mallika PS

Med J Malaysia, 2009 Dec;64(4):323-4.

PMID: 20954560 MyJurnal

A 14 year old boy underwent a 7 hour long spinal surgery for scoliosis in the prone position. In the immediate postoperative period, he developed right proptosis, periorbital swelling, chemosis and total ophthalmoplegia. The vision in his right eye was only counting fingers and the intraocular pressure was 68 mmHg. Fundus examination revealed occlusion of the right central retinal artery. A rare manifestation of both vein and artery occlusion was possible in this patient as a result of external ocular compression due to a prolonged period in the prone position. This report highlights the importance of being aware of the possible complications of external ocular compression in non-ocular surgery.

Matched MeSH terms: Retinal Artery Occlusion/etiology*

Central retinal artery occlusion following haemorrhage

Vijendran M, Suppiah K

Med J Malaysia, 1977 Sep;32(1):37-40.

PMID: 609341

Matched MeSH terms: Retinal Artery

Prevalence and risk factors of retinal arteriolar emboli: the Singapore Malay Eye Study

Cheung N, Lim L, Wang JJ, Islam FM, Mitchell P, Saw SM, et al.

Am J Ophthalmol, 2008 Oct;146(4):620-4.

PMID: 18639861 DOI: 10.1016/j.ajo.2008.05.033

To examine the prevalence and risk factors of retinal arteriolar emboli, a risk predictor of stroke, in an Asian population.

Matched MeSH terms: Retinal Artery*

Retinal vascular caliber, blood pressure, and cardiovascular risk factors in an Asian population: the Singapore Malay Eye Study

Sun C, Liew G, Wang JJ, Mitchell P, Saw SM, Aung T, et al.

Invest Ophthalmol Vis Sci, 2008 May;49(5):1784-90.

PMID: 18436813 DOI: 10.1167/iovs.07-1450

To describe the relationship of retinal vascular caliber with cardiovascular risk factors in an Asian population.

Matched MeSH terms: Retinal Artery/pathology*

Fulltext Antiphospholipid syndrome in lupus retinopathy

Ng HK, Chong MF, Azhany Y, Zunaina E

Clin Ophthalmol, 2014;8:2359-63.

PMID: 25473262 DOI: 10.2147/OPTH.S71712

Systemic lupus erythematosus (SLE) is a chronic, multisystem, autoimmune disease that can affect any part of the human body including the eyes. Common blinding ocular manifestations include central retinal artery occlusion (CRAO), central retinal vein occlusion (CRVO), severe vaso-occlusive retinopathy, and optic nerve involvement. Antiphospholipid syndrome (APS) in lupus is usually associated with large vessel occlusions and needs prompt treatment with anticoagulant. We are reporting two cases of APS in SLE patients that presented with CRVO (case 1) and vaso-occlusive lupus retinopathy (case 2). Both cases were positive for antiphospholipid antibody (APA) and were treated with immunosuppression, anticoagulant, and laser treatment. Thus, screening for APA is vital in SLE patients with lupus retinopathy, as prompt treatment with anticoagulants is important to prevent further vascular thrombosis, which worsens the visual prognosis.
Study site: Ophthalmology clinic, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia

Matched MeSH terms: Retinal Artery Occlusion

Fulltext Anterior penetrating chest injury with left ventricular thrombus

Ruth Sabrina, S., Nik Azlan, N.M., Adi, O.

Medicine & Health, 2013;8(1):28-32.

MyJurnal

Urban cities are synonym with a high incidence of penetrating chest injuries either from accidents or interpersonal violence. The outcome of penetrating chest wound can vary from immediate death to a prolonged morbidity. We here report a case of 39-year-gentleman who presented to Emergency Department Hospital Raja Permaisuri Bainun, Ipoh, Perak after being stabbed to the chest. His anterior penetrating chest wound was located at the 5th intercostal space medial to the midclavicular line. The stab wound penetrated the myocardium, causing minimal myocardial rupture. He also suffered from left haemothorax and hemopericardium. The haemothorax was drained with insertion of 32 French chest tube. The patient was admitted under the cardiothoracic team and discharged five days later without surgical intervention. He presented again to the Emergency Department with complains of shortness of breath and pleuritic pain. A left ventricular thrombus was detected via echocardiography. Unfortunately, he took his own discharge. Five days later he came again to Emergency Department with sporadic of loss of vision. The mural thrombus dislodged and embolized to the retinal artery causing amaurosis fugax. The patient was treated with aspirin 150mg and his symptoms subsequently resolved.

Matched MeSH terms: Retinal Artery

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