Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review

ABSTRACT Patent foramen ovale might cause cryptogenic strokes, including retinal artery occlusion. Herein, we describe a previously healthy young man who presented with central retinal artery occlusion in the setting of patent foramen ovale and explore the need for transesophageal echocardiogram for its diagnosis. Cardiovascular workup and neuroimaging were unremarkable. Transthoracic echocardiogram bubble study revealed a right to left atrial shunt and subsequent transesophageal echocardiogram disclosed patent foramen ovale. This congenital cardiac anomaly was the likely conduit for a thrombo-embolic central retinal artery occlusion. We identified seven patients with patent foramen ovale associated with central retinal artery occlusion in the literature. Transthoracic echocardiogram was diagnostic in only one patient (14.3%), whereas transesophageal echocardiogram was required to reveal patent foramen ovale in the remaining six (85.7%). Our case and the previous reports support the link between central retinal artery occlusion and patent foramen ovale. Therefore, providers should consider the more sensitive transesophageal echocardiogram during the initial evaluation of young patients without immediately identifiable causes of retinal artery occlusion.

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Main Authors: Wieder,Matthew S., Blace,Nancy, Szlechter,Moshe M., Shulman,Eric, Thankenchen,Jincy, Mbekeani,Joyce N.
Format: Digital revista
Language:English
Published: Conselho Brasileiro de Oftalmologia 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000500494
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spelling oai:scielo:S0004-274920210005004942021-09-17Central retinal artery occlusion associated with patent foramen ovale: a case report and literature reviewWieder,Matthew S.Blace,NancySzlechter,Moshe M.Shulman,EricThankenchen,JincyMbekeani,Joyce N. Retinal artery occlusion Foramen ovale, patent Transesophageal Echocardiography Case reports ABSTRACT Patent foramen ovale might cause cryptogenic strokes, including retinal artery occlusion. Herein, we describe a previously healthy young man who presented with central retinal artery occlusion in the setting of patent foramen ovale and explore the need for transesophageal echocardiogram for its diagnosis. Cardiovascular workup and neuroimaging were unremarkable. Transthoracic echocardiogram bubble study revealed a right to left atrial shunt and subsequent transesophageal echocardiogram disclosed patent foramen ovale. This congenital cardiac anomaly was the likely conduit for a thrombo-embolic central retinal artery occlusion. We identified seven patients with patent foramen ovale associated with central retinal artery occlusion in the literature. Transthoracic echocardiogram was diagnostic in only one patient (14.3%), whereas transesophageal echocardiogram was required to reveal patent foramen ovale in the remaining six (85.7%). Our case and the previous reports support the link between central retinal artery occlusion and patent foramen ovale. Therefore, providers should consider the more sensitive transesophageal echocardiogram during the initial evaluation of young patients without immediately identifiable causes of retinal artery occlusion.info:eu-repo/semantics/openAccessConselho Brasileiro de OftalmologiaArquivos Brasileiros de Oftalmologia v.84 n.5 20212021-10-01info:eu-repo/semantics/othertext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000500494en10.5935/0004-2749.20210073
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libraryname SciELO
language English
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author Wieder,Matthew S.
Blace,Nancy
Szlechter,Moshe M.
Shulman,Eric
Thankenchen,Jincy
Mbekeani,Joyce N.
spellingShingle Wieder,Matthew S.
Blace,Nancy
Szlechter,Moshe M.
Shulman,Eric
Thankenchen,Jincy
Mbekeani,Joyce N.
Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
author_facet Wieder,Matthew S.
Blace,Nancy
Szlechter,Moshe M.
Shulman,Eric
Thankenchen,Jincy
Mbekeani,Joyce N.
author_sort Wieder,Matthew S.
title Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
title_short Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
title_full Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
title_fullStr Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
title_full_unstemmed Central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
title_sort central retinal artery occlusion associated with patent foramen ovale: a case report and literature review
description ABSTRACT Patent foramen ovale might cause cryptogenic strokes, including retinal artery occlusion. Herein, we describe a previously healthy young man who presented with central retinal artery occlusion in the setting of patent foramen ovale and explore the need for transesophageal echocardiogram for its diagnosis. Cardiovascular workup and neuroimaging were unremarkable. Transthoracic echocardiogram bubble study revealed a right to left atrial shunt and subsequent transesophageal echocardiogram disclosed patent foramen ovale. This congenital cardiac anomaly was the likely conduit for a thrombo-embolic central retinal artery occlusion. We identified seven patients with patent foramen ovale associated with central retinal artery occlusion in the literature. Transthoracic echocardiogram was diagnostic in only one patient (14.3%), whereas transesophageal echocardiogram was required to reveal patent foramen ovale in the remaining six (85.7%). Our case and the previous reports support the link between central retinal artery occlusion and patent foramen ovale. Therefore, providers should consider the more sensitive transesophageal echocardiogram during the initial evaluation of young patients without immediately identifiable causes of retinal artery occlusion.
publisher Conselho Brasileiro de Oftalmologia
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000500494
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