Title
OCCLUSION OF THE CENTRAL ARTERY RETINA SECONDARY OF THE DISSECTION OF CAROTID IN A YOUNG PATIENT - CASE REPORT
Summary
INTRODUCTION Retinal central artery occlusion (OACR) is rare, more common over 60 years of age. Patients complain of visual loss. In the acute phase there is edema and retinal pallor, with the visualization of the choroidal circulation in the fovea, with a cherry red spot look. Many conditions are associated with OACR, with atherosclerosis of the carotid artery being the most common etiology. CASE REPORT VFS, male, 13 years old, complaint of sudden low visual acuity in the right eye (OR) after cervical torsion. No comorbidities. Presented corrected visual acuity (AVCC) OR: Light perception; The left eye was normal. Biomicroscopy OR: No changes / no afferent pupil defect. OR tonometry: 14 mmHg. Fundoscopy (FO) OR: Optical disc within the normal range, macula with cherry red aspect, diffuse retinal pallor, normal vessels, applied retina, vitreous and clear. Angiofluoresceinography (AGF): OR delayed arm-retina time and hyper fluorescence due to overflow in the macular region. OR OCT: loss of foveal depression, disorganization of the internal retinal layers, hypo reflective sub retinal image. Rheumatologic and infection research was negative. Carotid doopler echography evidence on right common carotid artery with flapping, highly suggestive of arterial dissection. After 30 days of treatment with oral anticoagulant with the vascular doctor: AVCC OR: 30 cm fingers count. FO OR: optical disc within normal range, decreased macular reflex, normal RPE, normal vessels, applied retina, clear vitreous. OCT OR: Attenuation of foveal depression, thinning of the internal retinal layers. METHODS Medical record review. DISCUSSION Carotid dissections can be spontaneous or post minor trauma such as turning the head quickly, poor posturacervical, coughing and sneezing. The classic triad is local pain, headache and Horner's syndrome. They can affect the ipsilateral eye with fleeting amaurosis, ischemia of the retina and optic nerve.
Area
CLINICAL CASE
Authors
RAIMUNDA CRISTINA M F DE OLIVEIRA, PAULO HENRIQUE HORIZONTE, ANDRE MARCELO VIEIRA GOMES, FERNANDA DE CASTRO ROLLO SAMPAIO, Amanda Venturini, RAFAEL GARCIA