Summary
Purpose
Retinal artery occlusions (RAO) cause sudden vision deterioration and visual field defects. While Albrecht von Graefe was the first to describe RAO in 1859, Hollenhorst reported about yellow plaques in the retinal arteries in 1961. Embolism from cardiac valves or plaques of the carotid artery are a common reason for RAO. Transesophageal echocardiography (TEE) has the potential to diagnose thrombotic material at the cardiac valves or plaques of the aortic arch with more precision than transthoracic echocardiography (TTE). Furthermore associations of RAO with arteriosclerosis is discussed.
Methods
117 patients with RAO, that had undergone TEE, were included in our retrospective study.
Results
Around 4.3 % of patients had thrombotic material at the cardiac valves, 10 % persistent foramen ovale, 54.7 % insufficient cardiac valves and 18.8 % plaques in the aortic arch. A total of 88 % of patients had at least one arteriosclerotic risk factor, 68 % arterial hypertension, 59.8 % hypercholesterolemia and 23.1 % diabetes mellitus. Moreover, 36.8 % had antithrombotic therapy and 67.3 % plaques in the internal carotid artery.
Conclusion
Alltogether, 40.2 % of patients had higher risk for thromboembolic complications, diagnosed with TEE.
Zusammenfassung
Hintergrund
Retinale arterielle Verschlüsse (RAO) verursachen plötzliche Visusverschlechterungen und Gesichtsfeldveränderungen. Die Erstbeschreibung der RAO erfolgte duch Albrecht von Graefe im Jahr 1859, Hollenhorst konnte 1961 über gelbe Plaques in den retinalen Gefäßen berichten. Embolisches Material von den Herzklappen oder Carotisplaques wird allgemein als Ursache für die RAO postuliert. Die Transösophageale Echokardiographie (TEE) hat das Potential solche Thromben besser als die Transthorakale Echokardiographie (TTE) aufzuzeigen. Unabhängig davon werden Assoziationen der RAO mit Arteriosklerose diskutiert.
Methode
117 Patienten/innen mit RAO, die eine TEE bei der Durchuntersuchung erhalten hatten, wurden in diese retrospektive Studie inkludiert.
Resultate
4,3 % der Patienten/innen hatten Vegetationen auf den Herzklappen, 10 % ein persistierendes Foramen ovale, 54,7 % Herzklappeninsuffizienzen und 18,8 % Plaques im Aortenbogen. 88 % der Patienten/innen hatten zumindest einen arteriosklerotischen Risikofaktor, 68 % arterielle Hypertension, 59,8 % Hypercholesterinämie und 23.1 % Diabetes mellitus. 36.8 % der Patienten/innen hatten thromboseprophylaktische Therapie und 67,3 % Plaques der Carotis Interna.
Schlussfolgerung
Zusammenfassend hatten 40,2 % der Patienten/innen ein höheres Risiko für eine thromboembolische Komplikation, entsprechend der in der TEE festgestellten Pathologien.
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Leisser, C. Risk factor analysis in patients with retinal artery occlusion with respect to transesophageal echocardiography. Spektrum Augenheilkd. 28, 118–120 (2014). https://doi.org/10.1007/s00717-014-0218-5
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DOI: https://doi.org/10.1007/s00717-014-0218-5
Keywords
- Retinal artery occlusion
- Transesophageal echocardiography
- Plaques of the carotid artery
- Arteriosclerosis