Ebook Ocular trauma: Part 2
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Ebook Ocular trauma: Part 2
Acute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2 room. The visual field loss could be caused by a variety of ocular as well as neurological disease processes. Successful diagnosis of visual field loss cases requires careful differential analysis of a wide variety of possibilities, complete examinations of medical and ocular history, and comprehen Ebook Ocular trauma: Part 2sive ophthalmic examinations. Ancillary tests play a major role in assisting the correct diagnosis of these diseases. Major causes of acute visual fieEbook Ocular trauma: Part 2
ld loss are discussed in this chapter.KeywordsBranch retinal artery occlusion (BRAO) Central retinal artery occlusion (CRAO) Branch retinal vein occluAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2uroretinitis6.1Branch Retinal Artery ObstructionBranch retinal artery obstruction (BRAO) is a retinal vascular disorder that is often associated with systemic diseases. When dealing with this disease, it is crucial for clinicians to determine the possible sources of obstruction. The diagnosis and sy Ebook Ocular trauma: Part 2stemic evaluation of these patients are critical.6.1.1Epidemiology and PathogenesisBranch retinal artery obstruction is a rare event, even less commonEbook Ocular trauma: Part 2
than central retinal artery obstruction (CRAO). It. however, more commonly occurred in younger patients than CRAO [ 1 ]. Men are more affected than wAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2ght eyeB. Huang (S3)Department of Ophthalmology. University ofMississippi Medical Center.Jackson 39216. MS. USA e-mail: bhuang@unw.edus. LiShandong Eye Hospital. Shandong Eye Institute.Qingdao. Chinac Springer Nature Singapore Pte Ltd. 201895H. Yan (ed.). Ocular Emergency, Ocular Trauma, https://doi Ebook Ocular trauma: Part 2.org/lO. 1007/978-981 -10-6802-7.6968. Huang and s. Li(60%) is affected more commonly than the left (40%). which likely reflects the greater possibiliEbook Ocular trauma: Part 2
ty of cardiac or aortic emboli traveling to the right carotid artery [2].A majority of the BRAOs are secondary to emboli blockage of the retinal circuAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2rt to the ophthalmic artery. The risk factors include predisposing family history, hypertension, elevated lipid levels, cigarette smoking, and diabetes mellitus.The three main types of retinal emboli are:•Cholesterol (Hollenhorst plaque)•Platelet-fibrin•CalcificThese retinal emboli have their own ch Ebook Ocular trauma: Part 2aracteristic appearances. Cholesterol emboli are typically formed from atheromatous plaques of the ipsilateral carotid artery system. They appear yellEbook Ocular trauma: Part 2
ow orange in color, refractile, and globular or rectangular in shape. Platelet-fibrin emboli are usually associated with carotid or cardiac thrombosesAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2tion of heart valves or the aorta.Other less common embolic types include tumor cells from atrial myxoma [51 or a systemic metastasis, septic emboli associated with septicemia or endocarditis, fat emboli associated with large bone fractures, emboli dislodged during angioplasty or angiography, and de Ebook Ocular trauma: Part 2pot drug preparations from intra-arterial injections around the eye or face.Local ocular conditions rarely produce BRAO. These include inflammatory diEbook Ocular trauma: Part 2
seases, such as toxoplasmosis or acute retinal necrosis, or structural entities, such as optic disc drusen or prepapillary arterial loops [2. 3|.SysteAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2ritis nodosa or local vasculitis associated with varicella infection, can also beassociated with branch retinal artery obstruction. Oral contraceptive use and cigarette smoking have been implicated as possible risk factors, especially in young, otherwise healthy women [1*8].6.1.2Ocular Manifestation Ebook Ocular trauma: Part 2sA characteristic ocular history of BRAO is acute painless loss of vision in the visual field corresponding to the territory of the obstructed artery.Ebook Ocular trauma: Part 2
Patients can typically relate to the precise time and extent of visual loss. In some cases, amaurosis fugax precedes artery obstruction in the settinAcute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Ebook Ocular trauma: Part 2depending on the extent of retinal involvement.A fundus examination will reveal retinal whitening that corresponds to the areas of ischemia. The ischemic area Stops at adjacent retinal veins, as these vessels mark the extent of the ten itory of the retinal arteries (Fig. 6.1). The clinicians can oft Ebook Ocular trauma: Part 2en identify the presence of retinal emboli in over two thirds of BRAOs. Flame hemorrhages and cotton-wool spots can also be seen on fundus exam.Acute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergency Acute Visual Field Impairment6Bo Huang and Suxia LiAbstractAcute visual field loss is a clinical sign that is frequently encountered in the emergencyGọi ngay
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