Role of transesophageal echocardiography in the evaluation of patients with retinal artery occlusion
Section snippets
Patients
Between July 1996 and December 1998, 22 patients were seen at the Department of Ophthalmology of Rabin Medical Center with retinal artery occlusion. Eighteen of them underwent TTE and TEE in the Echocardiography Unit as part of the routine systemic evaluation. The medical records were reviewed for current findings on electrocardiography, Doppler examination of carotid arteries, coagulation status, and for medical history. The four patients who did not undergo TEE included one patient who was
Results
The patient characteristics are shown in Table 1. There were 12 males and 6 females, with a mean age of 64.1 ± 10.3 years (range, 48–81 years). Six patients (33%) were less than 60 years of age. Eleven patients had branch retinal artery occlusion, and seven patients had central occlusion.
Review of the patients’ medical records revealed the following data: 11 patients (61%) had known cardiac pathology; 8 had a history of ischemic heart disease (4 had undergone coronary artery bypass surgery),
Discussion
Studies have shown that in the elderly the most common cause of retinal artery occlusion is an embolus caused by atheromatous plaque in the carotid artery.4 Severe stenosis of the ipsilateral carotid artery has been demonstrated in 45% of patients with retinal embolic events.5, 6 The causes in younger patients are diverse and most commonly include cardiac disorders (cardiac valvular heart disease,7, 8, 9, 10 left atrial myxoma11) and various hypercoagulable states leading to thrombosis.12
Acknowledgements
The authors wish to thank Mrs. Gloria Ginzach and Mrs. Marian Propp for their editorial and secretarial assistance.
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