Ophthalmodynamometric diagnosis of unilateral ischemic ophthalmopathy

Am J Ophthalmol. 2002 Dec;134(6):911-2. doi: 10.1016/s0002-9394(02)01813-5.

Abstract

Purpose: To describe a patient presenting with typical signs of vascular occlusive retinopathy.

Design: Observational case report.

Methods: A 65-year-old man experienced painless unilateral loss of vision to 4/20 in his left eye. Ophthalmoscopy of the left eye showed pronounced attenuation of the retinal arterioles, ischemic retinal edema, and a few intraretinal hemorrhages. Fluorescein angiography revealed a diffusely reduced retinal perfusion typical of retinal occlusive disease. Using a new ophthalmodynamometer with a pressure sensor at the mounting support of a conventional Goldmann contact lens, we additionally measured the diastolic central retinal artery collapse pressure.

Results: The diastolic central retinal artery collapse pressure was significantly lower in the left eye than in the right eye (14.7 +/- 2.4 relative units vs 51.7 +/- 4.3 relative units; P <.001). Both values were significantly (P =.03) lower than those in a control group (80.9 +/- 6.9 relative units). Doppler sonography revealed a total occlusion of the left carotid artery and a nonrelevant stenosis of the right carotid artery.

Conclusions: A new ophthalmodynamometric device consisting of a pressure sensor at the mounting support of a Goldmann contact lens was helpful in detecting carotid artery occlusion leading to ischemic ophthalmopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arterial Occlusive Diseases / diagnosis
  • Carotid Arteries / diagnostic imaging
  • Fluorescein Angiography
  • Humans
  • Ischemia / diagnosis*
  • Male
  • Ophthalmodynamometry / instrumentation
  • Ophthalmodynamometry / methods*
  • Ophthalmoscopy
  • Pressure
  • Retinal Artery / pathology*
  • Retinal Artery Occlusion / diagnosis*
  • Ultrasonography, Doppler
  • Visual Acuity