[Ocular blood flow defect in gaze-evoked amaurosis].
OBJECTIVE
To investigate the mechanism of gaze-evoked amaurosis.


METHODS
A patient with an optic nerve tumor presented gaze-evoked amaurosis. A large central scotoma and constricted visual field were detected after shifting the gaze laterally. However, the patient did not notice this change until his fellow eye was occluded. Computed tomography/magnetic resonance imaging (CT/MRI) demonstrated a tubularly enlarged optic nerve extending for 1 cm from the eye ball, and the condition was judged to be optic nerve sheath meningioma. He underwent fluorescein fundus angiography twice, once during straight gaze and again during lateral gaze.


RESULTS
Manifestly decreased blood flow in the central retinal artery and filling defect in the optic nerve head were seen during lateral gaze.


CONCLUSIONS
Forced lateral gaze may have increased the intra-optic nerve pressure at the optic nerve head and decreased the blood flow of the central retinal artery and peripapillary choroidal flow irrigating the optic nerve head.
Oohira
A
A
Department of Ophthalmology, Kosei Nenkin Hospital, Tokyo, Japan.
Kubo
R
R
D001766:Blindness / Q000209:etiology*; D005451:Fluorescein Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000150:complications; D008875:Middle Aged; D009898:Optic Disk / Q000098:blood supply*; D019574:Optic Nerve Neoplasms / Q000150:complications*; D012161:Retinal Artery / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014794:Visual Fields