Twenty-four percent of patients with retinal ischemia had concomitant brain ischemic lesions.

When monocular visual loss is secondary to retinal ischemia, the etiology usually is embolic. In this retrospective study of 129 patients who presented to a Boston emergency department with monocular visual loss of presumed ischemic origin, researchers sought to determine the prevalence of concurrent acute brain infarction (identified by diffusion-weighted magnetic resonance imaging [DWI]). Visual loss was transient in 57% of patients and permanent in 43%.

Thirty-one patients (24%) exhibited one or more acute ischemic lesions in the brain; in nearly all these patients, lesions were in the appropriate ipsilateral carotid-territory circulation. Seventeen patients had hemispheric symptoms in addition to monocular visual symptoms; as expected, such patients were significantly more likely to be DWI-positive than were patients without any hemispheric symptoms. Patients with identified embolic sources (generally large-artery atherosclerotic or cardiac) also were more likely to exhibit ischemic brain lesions on DWI than were patients without definite or probable sources.

CITATION(S):

Helenius J et al. Concurrent acute brain infarcts in patients with monocular visual loss. Ann Neurol 2012 Aug; 72:286.