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Ocular ischemic syndrome
Ocular ischemic syndrome is the constellation of ocular signs and symptoms secondary to severe, chronic arterial hypoperfusion to the eye.〔De Graeve C, Van de Sompel W, Claes C. ("Ocular ischemic syndrome: two case reports of bilateral involvement." ) ''Bull Soc Belge Ophtalmol.'' 1999;273:69-74. PMID 10546383.〕 Amaurosis fugax is a form of acute vision loss caused by reduced blood flow to the eye that may be a warning sign of an impending stroke. Consequently, those with transient blurring of vision are advised to urgently seek medical attention for a thorough evaluation of the carotid artery. Anterior segment ischemic syndrome is a similar ischemic condition of anterior segment usually seen in post-surgical cases. Retinal arterial occlusion leads to rapid death of retinal cells, thereby resulting in severe loss of vision.
==Symptoms and signs==
Those with ocular ischemic syndrome are typically between the ages of 50 and 80 (patients over 65) ;〔Friedberg MA, Rapuano CJ. ''The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease'', J.B. Lippincott, 1994.〕〔("Ocular Ischemic Syndrome." ) Accessed October 25, 2006.〕 twice as many men as women are affected.〔 More than 90% of those presenting with the condition have vision loss.〔 Patients may report a dull, radiating ache over the eye and eyebrow.〔 Those with ocular ischemic syndrome may also present with a history of other systemic diseases including arterial hypertension, diabetes mellitus, coronary artery disease, previous stroke, and hemodialysis.
The condition presents with visual loss secondary to hypoperfusion of the eye structures. The patient presents with intractable pain or ocular angina. On dilated examination, there may be blot retinal hemorrhages along with dilated and beaded retinal veins. The ocular perfusion pressure is decreased.
The corneal layers show edema and striae. There is mild anterior uveitis. A cherry-red spot in macula may be seen, along with cotton-wool spots elsewhere, due to retinal nerve fiber layer hemorrhages. The retinal arteries may show spontaneous pulsations.
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