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Transient Monocular Blindness

Published online by Cambridge University Press:  18 September 2015

R.T. Ross*
Affiliation:
Section of Neurology, Department of Medicine, University of Manitoba, Winnipeg, Canada
*
EEG Department, Health Sciences Centre, 700 William Avenue, Winnipeg R3E 0Z3, Canada
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Summary:

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This paper is a review of the causes of intermittent monocular blindness. The nature of cholesterol and platelet retinal emboli is discussed. Their sources, the frequency with which they may cause transient or fixed blindness and the association between these emboli and pathology of the major cerebral vessels and other organs is discussed.

Consideration is given to the equally important abnormalities of platelet behavior and to some of the physiology of retinal blood flow and non-embolic blindness.

The current treatment of this symptom may be anticoagulation, surgical correction of a stenotic artery or both. The effect of treatment is unpredictable and in some situations the rationale is suspect.

This review may provide a summary on which to base future studies of the effectiveness of various therapeutic agents.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1977

References

REFERENCES

Adson, A.W. (1942). Surgical Treatment of Vascular Diseases Altering the Function of the Eyes. Am. J. Ophthalmol., 25: 824838.Google Scholar
Alm, A. (1972). Effects of Norepinephine Angiotensin, dihydroergotamine, Papaverine, isoproterenol, histamine, nicotinic acid, and xanthinol nicotinate on retinal oxygen tension in cats. Acta Ophthalmol., 50: 707719.Google Scholar
Alm, A. and Bill, A. (1970). Blood flow and Oxygen extraction in the cat uvea at normal and high intraocular pressures. Acta Physiol. Scand. 80: 1928.Google Scholar
Alm, A. and Bill, A. (1972). The Oxygen Supply to the Retina II. Effects of High Intraocular Pressure and of Increased Arterial Carbon Dioxide Tension on Uveal, and Retinal Blood Flow in Cats. Acta Physiol. Scand. 84: 306319.CrossRefGoogle Scholar
Alm, A. and Bill, A. (1973a). Ocular and Optic nerve Blood Flow at Normal and Increased Intraocular Pressures in Monkeys (Macaca Irus): A Study with radioac-tively labelled microspheres including flow determinations in brain and some other tissues. Exptl. Eye Res. 15: 1529.Google Scholar
Alm, A. and Bill, A. (1973b). The Effect of Stimulation of the Cervical Sympathetic Chain on Retinal Oxygen Tension and on uveal retinal and cerebral blood flow in cats. Acta Physiol. Scand. 88: 8494.Google Scholar
Ashton, N. (1968). Some Aspects of the Comparative Pathology of Oxygen Toxicity in the Retina. Br. J. Ophthalmol., 52: 505531.Google Scholar
Bill, A. (1962). Autonomic Nervous Control of Uveal Blood Flow. Acta Physiol. Scand. 56: 7081.CrossRefGoogle ScholarPubMed
Bill, A. (1975). Blood Circulation and Fluid Dynamics in the Eye. Physiol. Rev. 55: 383417.Google Scholar
Bruner, A.S. (1921). Spasm of the Central Retinal Artery. Am. J. Ophthalmol., 4: 503506.CrossRefGoogle Scholar
Buettner, H.R., Machemer, S., Anderson, C. and et al. (1973). Experimental Derivation of Choroidal Blood Flow. Retinal Morphology, early receptor potential and electroretinography. Am. J. Ophthalmol., 75: 943952.CrossRefGoogle Scholar
Bulpitt, C.J. and Dollery, C.T. (1971). Estimation of the Retinal Blood Flow by Measurement of the Mean Circulation Time. Cardiovas. Res. 5: 406412.Google Scholar
Carvalho, A.C.A., Colman, R.W. and Lees, R.S. (1974). Platelet function in hyperlipoproteinemia. N. Engl. J. Med., 290: 434438.CrossRefGoogle ScholarPubMed
Chandra, S.R. and Friedman, E. (1972). Choroidal Blood Flow II. The effects of autonomic agents. Arch. Ophthalmol., 87: 6769.Google Scholar
Clay, C. and Vignaud, J. (1971). Vascularisation de l’orbite. Encyclopédie medico-chirurgicale, Paris. 21: 006.Google Scholar
Cumulated Index Medicus (1973). 14: 76417643.Google Scholar
Cumulated Index Medicus (1973). 16: 51955198.Google Scholar
Dandy, W.E. (1935). The Treatment of Carotid Cavernous Arteriovenous Aneurysms. Ann. Surg., 102: 916926.Google Scholar
David, N.J., Klintworth, G.K., Friedberg, S.J. and Dillon, M. (1963). Fatal Atheromatous Cerebral Embolism Associated with Bright Plaques in the Retinal Arterioles. Neurology (Min-neap.) 13: 708713 (1963).Google Scholar
David, T.E., Humphries, A.W., Young, J.R. et al. (1973). A correlation of neck bruits and arteriosclerotic carotid arteries. Arch. Surg., 107: 729731.CrossRefGoogle ScholarPubMed
Deykin, D. (1974). Emerging Concepts of Platelet Function. N. Engl. J. Med., 290: 144151.Google ScholarPubMed
Dollery, C.T., Bulpitt, C.J. and Kohner, E.M. (1969). Oxygen Supply to the retina from the retinal and choroidal circulations at normal and increased arterial oxygen tensions. Invest. Ophthalmol.. 8: 588594.Google Scholar
Dyll, L.M., Margolis, M. and David, N.J. (1966). Amaurosis Fugax. Neurology (Minneap.) 16: 135138.Google Scholar
Ehinger, B. (1966). Adrenergic nerves to the eye and to related structures in man and in the cynomolgus monkey. Invest. Ophthalmol.. 5: 4252.Google Scholar
Ffytche, T.J., Bulpitt, C.J., Kohner, E.M. et al. (1974). Effect of changes in Intraocular Pressure on the Retinal Microcirculation. Br. J. Ophthalmol.. 58: 514522.CrossRefGoogle ScholarPubMed
Fisher, C.M. (1959). Observations of the Fundus Oculi in Transient Monocular Blindness. Neurology (Minneap.) 9: 333347.CrossRefGoogle ScholarPubMed
Friedman, E. and Chandra, S.R. (1972). Choroidal Blood Flow III. Effects of Oxygen and Carbon Dioxide. Arch. Ophthalmol., 87: 7071.Google Scholar
Gerstenfeld, J. (1964). The Fundus Oculi in Amaurosis Fugax. Am. J. Ophthalmol.. 58: 198205.CrossRefGoogle Scholar
Gurdjian, E.S., Hardy, W.G., Linder, D.W. et al. (1962). Occlusive cerebrovascular disease. Diagnostic evaluation and treatment. Tr. Am. Acad. Ophthalmol. & Otolaryngol.. 66: 149165.Google ScholarPubMed
Harbridge, D.F. (1906). Monocular Visible Spasm of the Central Artery of the Retina. Ophthalmol. 2: 647653.Google Scholar
Hollenhorst, R.W. (1958). Ocular Manifestations of Insufficiency on Thrombosis of the Internal Carotid Artery. Trans. Am. Ophthalmol. Soc. 56: 474506.Google Scholar
Hollenhorst, R.W. (1960). The Ocular Manifestations of Internal Carotid Arterial Thrombosis. Med. Clin. North Am.. 44: 897908.Google Scholar
Hollenhorst, R.W. (1961). Significance of Bright Plaques in the Retinal Arterioles. JAMA 178, 2329.CrossRefGoogle ScholarPubMed
Hollenhorst, R.W. (1962). Carotid and Vertebral Basilar Arteriole Stenosis and Occlusion: Neuro-Ophthalmologic Consid-erations. Tr. Am. Acad. Ophthalmol. & Otolaryng., 66: 166180.Google Scholar
Hollenhorst, R.W. (1966). Vascular Status of Patients who have Cholesterol Emboli in the Retina. Am. J. Ophthalmol.. 61: 11591165.CrossRefGoogle ScholarPubMed
Laties, A.M. (1967). Central retinal Artery Innervation. Arch. Ophthalmol.. 77: 405409.Google Scholar
Lemak, N.A. and Fields, W.S. (1976). The Reliability of Clinical Predictors of Extracranial Artery Disease. Stroke 7: 377378.Google Scholar
Marshal, J. and Meadows, S. (1968). The Natural History of Amaurosis Fugax. Brain 91: 419433.CrossRefGoogle Scholar
McBrien, D.J., Bradley, R.D. and Ashton, N. (1963). Retinal Emboli in Stenosis of the Internal Carotid Artery. Lancet 1: 697699.Google Scholar
Mount, L.A. (1959). Results of treatment of Intracranial Aneurysms using the Selver-stone Clamp. J. Neurosurg., 16: 611618.Google Scholar
Poppen, J.L. and Fayer, C.A. (1960). Intracranial Aneurysms: Results of Surgical Treatment. J. Neurosurg., 17: 283296.Google Scholar
Ramirez-Lassepas, M., Sandok, B.A. and Burton, R.C. (1973). Clinical Indicators of Extracranial Carotid Artery Disease in Patients with Transient Symptoms. Stroke 4: 537540.Google Scholar
Ruskell, G.L. (1971). Facial Parasympathetic Innervation of the Choroidal Blood Vessels in Monkeys. Exptl. Eye Res. 12: 166172.Google Scholar
Russell, R.W. Ross, (1961). Observations on the Retinal Blood Vessels in Monocular Blindness. Lancet 2: 14221428.Google Scholar
Russell, R.W. Ross, (1963). Atheromatous Retinal Embolism. Lancet 2: 13541365.Google Scholar
Sanders, T.E. (1939). Intermittent Occlusion of the Central Retinal Artery. Am. J. Ophthalmol., 22: 861869.Google Scholar
Skovborg, F. and Lauritzen, E. (1965). Symptomless Retinal Embolism. Lancet 1: 361362.Google Scholar
Smith, P. (1962). Differential Carotid Ligation for Supraclinoid Arterial Cerebral Aneurysms. J. Neurosurg. 19: 787792.Google Scholar
Tsacopoulos, M., Baker, R. and Johnson, M. (1973). The Effect of Arterial pCO2 on inner retinal oxygen availability in monkeys. Invest. Ophthalmol. 12: 449455.Google Scholar
Walsh, P.N. (1972). The Role of Platelets in the contact phase of blood coagulation. Br. J. Haematol. 22: 237254.Google Scholar
Walsh, P.N. and Biggs, R. (1972). The Role of PLatelets in intrinsic factor Xa formation. Br. J. Haematol. 22: 743760.Google Scholar
Walsh, P.N., Pareti, F.I. and Corbett, J.J. (1976). Platelet Coagulant Activities and serum lipids in Transient Cerebral Ischemia. N. Engl. J. Med.. 295: 854858.Google Scholar
Weiter, J.J., Schachar, R.A. and Ernest, J. (1973). Control of Intraocular Blood Flow. Effects of Sympathetic Tone. Invest. Ophthalmol., 12: 332334.Google ScholarPubMed