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At least 19 recordsLinked to original sources
PubMed2003

Penetration of the optic nerve by an internal carotid artery-ophthalmic artery aneurysm: case report and literature review.

OBJECTIVE AND IMPORTANCE: Although it is well known that large or giant internal carotid artery-ophthalmic artery aneurysms can cause visual deficits, penetration and schism of the optic nerve by an aneurysm are very rare. CLINICAL PRESENTATION: A 48-year-old man presented with an acute onset of right visual deterioration after an episode of severe headache. Magnetic resonance imaging demonstrated penetration of the right optic nerve by an intracranial aneurysm. Cerebral angiography revealed an internal carotid artery-ophthalmic artery aneurysm of 12 x 7 mm. The aneurysm was directed superomedially and appeared to have a "waist" within the penetration. INTERVENTION: Intraoperatively, we observed that part of the aneurysm wall was visible through the optic nerve fibers at the junction with the optic chiasm. CONCLUSION: Although there was no direct evidence of subarachnoid hemorrhage on imaging scans or with operative exploration, we think that the patient must have experienced sentinel hemorrhaging, leading to visual deterioration. We describe the case in detail and review the world literature.

Aneurysm↗
PubMed2003

Three-dimensional blood flow analysis in a wide-necked internal carotid artery-ophthalmic artery aneurysm.

OBJECT: The aim of this study was to evaluate axial and secondary flow structures in a wide-necked internal carotid artery-ophthalmic artery aneurysm, one of the most common locations for endovascular coil placement. METHODS: A clear acrylic aneurysm model was manufactured from a three-dimensional computerized tomography angiogram. Intraaneurysm blood flow analysis was conducted using an acrylic aneurysm model together with laser Doppler velocimetry and particle imaging velocimetry. The maximal axial blood flow velocities in the inflow and outflow zones at the aneurysm orifice were noted at the peak systolic phase, measuring 46.8 and 24.9% of that in the parent artery, respectively. The mean size of the inflow zone during one cardiac cycle was 44.3 +/- 9.8% (range 35.6-58.7%) the size of the axial section at the aneurysm orifice. In the lower and upper planes of the aneurysm dome, the mean size of inward and outward flow areas were 43.3 +/- 6.7% and 43.8 +/- 6.8% the size of the axial cross-sectional plane, respectively. The axial flow velocity structures were dynamically altered throughout the cardiac cycle, particularly at the aneurysm orifice. The fastest secondary flow at the opening was also noted at the peak systolic and early diastolic phases. Axial blood flow velocity was slower in the upper axial plane of the aneurysm dome than in the lower one. Conversely, the secondary flow component was faster in the upper plane. CONCLUSIONS: The side-wall aneurysm in this study did not demonstrate a simple flow pattern as was previously seen in ideally shaped experimental aneurysms in vitro and in vivo. The flow patterns of inflow and outflow zones were very difficult to predict based on the limited flow information provided on standard digital subtraction angiography, even in an aneurysm with a relatively simple dome shape.

Aneurysm↗
PubMed1999

Continued lodging of retinal emboli in a patient with internal carotid artery and ophthalmic artery occlusions.

Internal carotid artery or ophthalmic artery occlusions are devastating ophthalmological events which lead to severe impairment of vision. A case of multiple branch retinal artery occlusions in a 63-year-old male with internal carotid artery and ophthalmic artery occlusions on brain angiography is presented. Emboli lodging in branches of the retinal arteries were bright, glistening, yellow or orange in appearance. Such a distinctive ophthalmoscopic appearance led to the diagnosis of cholesterol emboli. Fluorescein and indocyanine green angiography disclosed delayed filling of the retinal vessels and choroid, and showed multiple hypofluorescence distal to the vessels in which the emboli were lodged. At the time of initial examination, the number of emboli lodged in retinal arteries was estimated at more than 20. As time passed, a few of the previous emboli disappeared and new emboli appeared in other sites on fundus examination. We think that the lodging of new emboli in other sites is due to the continued break-up of atheromatous tissue through the collateral circulation associated with the occlusion of the internal carotid and ophthalmic arteries.

Acute Disease↗
PubMed1997

Combined intravascular parent artery and ophthalmic artery occlusion for giant aneurysms of the supraclinoid internal carotid artery.

BACKGROUND: Parent artery occlusion is an effective method to treat internal carotid giant aneurysms. However, incomplete parent artery occlusion may cause revascularization. Here, a modification of the parent artery occlusion procedure for giant aneurysms of the internal carotid artery is described. METHODS: Three patients with giant aneurysms of the internal carotid artery at the supraclinoid portion between the origin of the ophthalmic artery and the posterior communicating artery were treated by a combination of parent artery occlusion and occlusion of the origin of the ophthalmic artery. All patients had a giant aneurysm that manifested as cranial nerve palsy due to mass effect. RESULTS: A balloon occlusion test of the ipsilateral internal carotid artery together with the ophthalmic artery showed that permanent occlusion was tolerable. It was confirmed that the ipsilateral eye was supplied by maxilloophthalmic anastomosis instead of the ophthalmic artery. Cranial nerve palsy and visual acuity were markedly improved in two cases after the therapy. Follow-up selective internal and external carotid angiography did not demonstrate the aneurysm. CONCLUSIONS: Combined parent artery and ophthalmic artery occlusion is an effective treatment for a giant aneurysm located between the ophthalmic artery and the posterior communicating artery.

Adult↗
PubMedDate not supplied

[The hemodynamic characteristics of the central retinal artery and ophthalmic artery in atherosclerotic lesions of the carotid arteries based on the data from ultrasonic study methods].

Central retinal artery and orbital artery were examined by ultrasonograph in 348 patients with atherosclerosis of the carotid arteries. Doppler shift of frequency spectrum was detected in the central retinal artery, which is typical of the ischemic syndrome of the eye. Its characteristics include decreased diastolic component of velocity and increased resistance index. The possibility of using duplex scanning with color Doppler flow mapping for assessing the treatment efficacy is demonstrated. A direct relationship between the degree of stenosis in the internal carotid artery and blood flow in the orbital artery is revealed. The detected changes do not notably affect the Doppler spectrum characteristics in the central retinal artery.

Acute Disease↗
PubMedDate not supplied

The anatomy and clinical significance of the collateral circulation between the internal and external carotid arteries through the ophthalmic artery.

Complete occlusion of the internal carotid artery is not necessarily associated with total disruption of cerebral blood flow distal to the site of the arterial obstruction. In fact, the flow of blood may be sufficient to maintain cerebral perfusion. This is accomplished by the shunting of blood from the external to the internal carotid artery by means of collateral circuits. While several major branch arteries of the external carotid artery may be recruited in this process, the ophthalmic artery is often the final common pathway before the anastomosis with the internal carotid artery. With the aim of elucidating these collateral circles, digital subtraction angiography was used to examine 100 patients with total occlusion of the internal carotid artery. These data were compared with those obtained using Doppler ultrasound, duplex scanning, and transcranial Doppler. Forty patients were excluded because there was no demonstrable collateral circulation, because the collateral circulation used the communicating arteries, or because the ophthalmic artery arose from the middle meningeal artery. Dynamic data were obtained by compressing the branches of the two external and common carotid arteries, and the blood vessels were identified by comparison with previous anatomic studies. We have constructed a precise map of the intra- and extracranial circles that connect the internal and external carotid arteries through the pathways that include the ophthalmic artery. This map demonstrates why apparently identical vascular occlusions may have divergent symptomatologies and clinical outcomes, which may range from the complete absence of symptoms to cerebral infarction.

Aged↗
PubMed1993

Mechanisms of histamine-induced relaxation in external and internal ophthalmic arteries.

PURPOSE: Mechanisms that underlie the relaxant response to histamine were examined in dog external (a branch of external carotid artery) and internal (a branch of internal carotid artery) ophthalmic arteries (EOA and IOA). METHODS: Changes in isometric tensions were recorded in helical strips of the arteries with and without the endothelium. RESULTS: Histamine predominantly produced relaxations in EOA and IOA, partially contracted with prostaglandin (PG) F2 alpha. The relaxation of IOA almost was abolished by treatment with cimetidine (10(-5) mol/l), whereas the response of EOA was partially attenuated by treatment with cimetidine or chlorpheniramine (10(-6) mol/l) and was abolished with their combined treatment. Endothelium denudation depressed the relaxation in EOA but did not affect the response of IOA. The response to histamine of EOA was inhibited by treatment with indomethacin (10(-6) mol/l) or tranylcypromine (10(-4) mol/l), a PGI2 synthesis inhibitor, only when the endothelium was present, but additional treatment with chlorpheniramine did not further inhibit relaxation. On the other hand, IOA's response to histamine was not inhibited by indomethacin, despite the presence of endothelium. CONCLUSIONS: The histamine-induced relaxation in EOA may be associated with the release of vasodilator PGI2 through the activation of H1 receptors in the endothelium and with the direct action on H2 receptors in smooth muscle, whereas the relaxation in IOA is mediated exclusively by H2 receptors in smooth muscle.

Animals↗
PubMed1987

[Agenesis of the left internal carotid artery with an ophthalmic artery arising from the posterior communicating artery].

A case of agenesis of left internal carotid artery is reported. The patient is a forty one-year-old house-wife with sudden episode of headache when she had a fever. CT scan of the head showed a small high density area in the right frontotemporal subcortical region. Four vessel cerebral angiography demonstrated negative lesion except for complete absence of the left internal carotid artery. The blood supply to the left cerebral hemisphere was provided both through the tortuous anterior communicating artery and through the enlarged left posterior communicating artery. Left ophthalmic artery arose from the left posterior communicating artery. The embryological developmental process of this kind of vascular anomaly as well as the relationship between intravascular hemodynamic stress and the induction of cerebral aneurysm were discussed in detail.

Adult↗
PubMed2002

Retinal manifestations of ophthalmic artery hypoperfusion.

Ophthalmic artery hypoperfusion is a relatively uncommon clinical entity. This study illustrates the posterior segment findings of ophthalmic artery hypoperfusion in a series of nine patients. Colour photographs and relevant fluorescein angiograms highlighting the findings are shown. The retinal manifestations of ophthalmic artery hypoperfusion in this series of patients include midperipheral haemorrhages, dilated retinal veins, optic disk collaterals, optic disk neo-vascularization, cotton wool spots, grey intraretinal lesions, fundus pallor, optic disk swelling and choroidal infarcts. Recognition of the ophthalmic changes in this condition may lead to detection of carotid artery disease, the surgical and medical treatment of which has important bearing on patient management.

Aged↗
PubMed1992

Estimation of blood flow in the carotid artery and intraorbital ophthalmic artery by color pulse Doppler ultrasonography.

Blood flow velocity was estimated in the orbital part of the ophthalmic artery and in the carotid artery, by way of pulse Doppler ultrasonography. The equipment was a Toshiba SSA-270A machine. The material comprised 12 glaucoma patients (20 eyes, all with open angles) under satisfactory IOP control, mean age 52 years, and 28 healthy controls (mean age 40 years; 54 eyes). Systolic flow velocities of 46 cm/sec and 103 cm/sec, in the ophthalmic and carotid artery respectively, were found in the normal subjects. With mean values of 42 and 116 cm/sec in the glaucoma group there was no significant difference between groups. The same applied to the average flow velocities. A considerable interindividual variation was found.

Adult↗
PubMedDate not supplied

[Arterial pressure in the ophthalmic artery as a diagnostic test in autoimmune thyroiditis].

Arterial pressure in the ophthalmic artery was studied in 73 patients (135 eyes) with autoimmune thyroiditis in different thyroid function. A rise of diastolic and systolic pressure in the ophthalmic artery was noted in all groups of patients. It could be accounted for by a high degree of activation of the hypothalamic region as a result of sharp deficiency of thyroid hormones. Raised arterial pressure in the ophthalmic artery in patients with euthyroidism made it possible to recommend this method for early diagnosis of autoimmune thyroiditis.

Adult↗
PubMed2002

Combined central retinal arterial and venous obstruction: emergency ophthalmic arterial fibrinolysis.

PURPOSE: To investigate the role of urokinase selectively perfused into the ophthalmic artery as an emergency treatment for combined central retinal arterial obstruction (CRAO) and central retinal venous obstruction (CRVO). MATERIALS AND METHODS: Over a 6-year period, 11 consecutive patients presented with recent combined CRAO and CRVO (< or =72 hours). Urokinase (300,000 IU) was selectively perfused via the femoral artery into the ophthalmic artery for 40 minutes. Evaluation criteria were Snellen visual acuity with best correction, funduscopic results, and retinal arteriovenous transit time assessed over a mean 3.5-year follow-up. Mean vision and retinal perfusion were tested by means of repeated-measures analysis of variance. The correlation between visual improvement and retinal perfusion improvement was evaluated by means of Spearman rank correlation. RESULTS: Substantial improvement in vision and retinal perfusion was noted in seven of the 11 patients treated. Mean vision improvement was significant (P =.009) within 24-48 hours after fibrinolysis, increased until 1 month after (P =.006), then remained stable throughout the follow-up (P >.10). Visual improvement correlated with retinal perfusion improvement during the period from before fibrinolysis to 24-48 hours after (P =.028). In all patients with improved results, retinal hemorrhages transiently increased. One patient had intravitreal hemorrhage shortly after fibrinolysis. CONCLUSION: For this uncommon clinical entity, which typically has a poor visual outcome, these results suggest that ophthalmic arterial fibrinolysis may restore retinal perfusion, which leads to rapid substantial visual improvement in many cases of combined CRAO and CRVO, without systemic complications, but it may be responsible for intravitreal hemorrhage.

Adult↗
PubMed1992

Low concentrations of lithium and cyclooxygenase inhibitors enhance endothelin-1 (ET-1)-induced contractions in human temporal artery, but not in porcine ophthalmic artery.

Endothelins are a recently discovered group of potent vasoconstrictor peptides synthesized by endothelial cells and other tissues in various species, which seem to participate in the regulation of vascular tonus. Abnormalities in vasoactivity in the head may be an important event in headache pathophysiology, although the mechanisms responsible for such constrictions and/or dilations are not known. The endothelium and its constrictor peptide, endothelin, may play a key role in such mechanisms. Of the various drugs used in the treatment of headache, lithium is an accepted treatment for cluster headache, and indomethacin is the drug of choice for the associated condition chronic paroxysmal hemicrania. The mechanism of action of these drugs in these headaches is not known. Due to the possible involvement of endothelin in headache disorders, the objective of this study was to verify the effects of lithium and cyclooxygenase inhibitors (indomethacin, acetylsalicylic acid and naproxen) on endothelin-1 (ET-1)-induced contractions in isolated human temporal arteries and porcine ophthalmic arteries. It was found that all drugs increased the (ET-1)-induced contractions in human temporal arteries. Conversely, there were no significant changes induced by the drugs in porcine ophthalmic arteries. These results are consistent with the variation of activity often seen in different vascular beds and between species. The potential importance of such reactions for the understanding of vascular changes putatively involved in headache development and treatment is discussed.

Animals↗
PubMedDate not supplied

Relationship between ophthalmic artery blood flow and recanalization of occluded carotid artery. Ultrasonic Doppler study.

Ophthalmic artery blood flow in 5 patients with internal carotid artery occlusion of sudden onset was monitored by an ultrasonic Doppler flowmeter to investigate the possible relationship to spontaneous recanalization of the occluded artery. The occluded internal carotid arteries of 2 patients were confirmed angiographically to recanalize and the reversed flow of their ophthalmic arteries changed to physiological flow after the recanalization. The ophthalmic artery blood flow remained reversed in 2 patients whose occluded internal carotid arteries did not recanalize on the follow up angiograms. In the other patient, whose ophthalmic artery blood flow was not detected by the ultrasonic Doppler flowmeter in the acute stage, physiological flow through the ophthalmic artery was detected later. The occluded internal carotid artery did not recanalize and this physiological ophthalmic artery blood flow was filled through the circle of Willis.

Acute Disease↗
PubMedDate not supplied

Carotid occlusive disease: effect of complete occlusion of internal carotid artery on intraocular pulse/pressure relation and on ophthalmic arterial pressure.

The intraocular pressure (IOP), the intraocular pulse to pressure (pulse/pressure) relationship, and the ophthalmic arterial pressure have been measured in 20 patients with either unilateral or bilateral hemodynamically significant lesions of the internal carotid arteries (ICA) as determined from arteriography. Studies were repeated in 5 of hte patients after surgical endarterectomy on the obstructed ICA. In age matched normal subjects the pulse/pressure relations were symmetrical in pairs of eyes, and the ophthalmic arterial systolic pressure was 89.0 +/- 2.1 mm Hg; this was 66 +/- 1% of the brachial arterial systolic pressure. In 19 of 20 patients with carotid occlusive disease in this study the IOP, pulse amplitudes and the pulse/pressure relationships differed in pairs of eyes. The ophthalmic arterial systolic pressure on the sides with 95 to 100% ICA stenosis was 49.9 +/- 4.05 mm Hg, which was 33 +/- 3% of the brachial arterial systolic pressure. In the remaining eyes the degree of stenosis of the ipsilateral ICA was 36.5 +/- 7.9%; the corresponding eyes had an ophthalmic arterial systolic pressure of 70.f1 +/- 51.18 mm Hg, which was 45 +/- 4% of the brachial arterial systolic pressure. Endarterectromy of the occluded arteries caused a significant increase in the ophthalmic arterial pressure on the ipsilateral side and a smaller increase in the contralateral eye; these changes were associated with a statistically significant increase in the intraocular pulse and improvement in the pulse/pressure relation.

Aged↗