[Open foramen ovale in patients with arterial vascular occlusions of the retina and optic nerve].
BACKGROUND
We examined the frequency and significance of persistent foramen ovale (PFO) in patients with ocular circulatory disturbance.


METHODS
Forty patients with acute arterial occlusions of the posterior bulb segment were investigated by means of transthoracic and transesophageal echocardiography (TEE). The parallel presence of cerebral ischemia was clarified on the basis of existing CCT findings and by additional HMPAO-SPECT investigation.


RESULTS
PFO was identified in nine of the patients investigated. The probability of paradoxical embolism arises from further findings: eight of those with PFO (89%) showed echocardiographic signs of right heart strain, indicating previous pulmonary embolism, compared with only three of those without PFO (10%). Five of those with PFO showed a potential source of embolism, two of them with phlebothromboses in their clinical history and three with additional atrial septal aneurysm. Cardiovascular risk factors were prevalent in the group without PFO. Both groups had a mean age of approximately 60 years. Signs of cerebral ischemia were present in the SPECT or CT findings for four of the patients with PFO and nine of those without.


CONCLUSIONS
From our findings, it appears highly probable that ocular arterial occlusion is caused by paradoxical embolism. PFO should be taken into account in establishing a diagnosis, including diagnosis in elderly patients.
Steuber
C
C
Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg.
Panzner
B
B
Steuber
T
T
Krause
A
A
Teichmann
W
W
Mende
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000098:blood supply*; D015356:Retinal Artery Occlusion / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors
Offenes Foramen ovale bei Patienten mit arteriellen Gefässverschlüssen der Netzhaut und des Sehnervs.