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Ocular ischaemic syndrome in thyroid eye disease, confirmed using magnetic resonance angiography
  1. A J Shortt1,
  2. T Fulcher1,
  3. D Conroy2
  1. 1Institute of Ophthalmology, Mater Misericordiae Hospital, Dublin, Ireland
  2. 2Department of Radiology, Mater Misericordiae Hospital, Dublin, Ireland
  1. Correspondence to: Dr Alex J Shortt, Institute of Ophthalmology, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland; alexjshortt{at}eircom.net

https://doi.org/10.1136/bjo.87.10.1302

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    Ocular ischaemic syndrome (OIS) is most commonly caused by severe ipsilateral carotid artery stenosis.1–3 Occasionally it is caused by ophthalmic artery stenosis.4,5 Features commonly observed are iris neovascularisation, angle neovascularisation, rubeotic glaucoma, and iritis. In the posterior segment common signs are narrowing of the retinal arterioles, mid-peripheral retinal haemorrhages, optic disc pallor or neovascularisation and, rarely, retinal neovascularisation. Fluorescein angiography characteristically demonstrates delayed filling of the retinal circulation and occasionally patchy filling of the choroidal circulation is also observed.1–3 To the best of our knowledge OIS has not previously been described in thyroid eye disease. We report a case of OIS in thyroid eye disease confirmed by magnetic resonance angiography (MRA) and treated by orbital decompression.

    Case report

    A 48 year old woman with known thyroid eye disease presented with a 4 week history of pain, redness, and reduced visual acuity in her right eye. Eight years previously she had undergone bilateral three wall orbital decompression for severe corneal exposure. On examination visual acuity was counting fingers in the right eye and 6/9 …

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      BMJ Publishing Group Ltd.BMA House, Tavistock Square, London, WC1H 9JR
      British Journal of Ophthalmology 2004; 88 977-977 Published Online First: 17 Jun 2004.