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A. Takahashi, T. Nagaoka, A. Yoshida; Retinal Blood Velocity Waveforms in Patients With Branch Retinal Artery Occlusion: Case Reports. Invest. Ophthalmol. Vis. Sci. 2009;50(13):390.
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To report changes in the retinal circulation and blood velocity waveforms in the retinal arterioles evaluated by laser Doppler velocimetry (LDV) in patients with acute branch retinal artery occlusion (BRAO).
Retrospective case series.
Case 1: A 45-year-old woman with transient BRAO in the right eye with a visual acuity (VA) of 20/200. On the initial examination, retinal whitening and thickening were noted superotemporally. Fluorescein angiography showed normal retinal perfusion and no arterial obstruction. LDV (Canon CLBF-100) showed decreased blood velocity and flattened blood velocity waveforms in the diastolic phase in the affected area. Following ocular massage, the VA improved to 20/20 and the flattened blood velocity waveforms normalized in the affected area. No occlusion of the carotid artery was observed. Case 2. A 48-year-old man with multiple BRAO in the right eye with a VA of 20/20 due to foveal sparing. The retinal blood velocity waveforms were normal, but the peak systolic velocities and the end-diastolic velocities, 26 mm/sec and 11 mm/sec, respectively, in the temporal retinal artery in the right eye were lower than those, 54 mm/sec and 21 mm/sec, at the same point in the left eye. After ocular massage, the blood velocity waveforms and velocities were unchanged in the right eye. Carotid angiography showed complete occlusion of the right internal carotid artery.
This is the first report to examine the sequential changes in the blood velocity waveforms in the retinal artery using LDV in patients with acute transient BRAO. The findings in case 2 indicate that this is probably related to carotid artery occlusion. LDV was useful for evaluating the retinal circulation in BRAO and presuming the lesion in the carotid artery.
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