title: Role of transesophageal echocardiography in the evaluation of patients with retinal artery occlusion.
abstract: OBJECTIVE
  To evaluate the role of transesophageal echocardiography (TEE) in detecting cardiac and thoracic aortic sources of retinal emboli.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  The study population consisted of 18 patients who were initially seen with retinal artery occlusion (7 central, 11 branch) and underwent TEE as part of the systemic evaluation.
  
  
  METHODS
  All patients underwent TEE, consisting of complete two-dimensional and Doppler color flow examinations. TEE was done immediately after transthoracic echo (TTE) examination. The medical records were reviewed.
  
  
  METHODS
  Detection of a possible cardiac or thoracic aortic source of retinal embolus.
  
  
  RESULTS
  Cardiac or thoracic aortic pathologic conditions, which were a possible source of the retinal emboli, were detected by TEE in 13 of the 18 patients (72%). They included aortic arch atheroma (n = 7), mitral annulus calcification (n = 4), left atrial appendage thrombus (n = 2), valvular abnormalities (n = 5), left atrial smoke (n = 3), and patent foramen ovale (n = 3). In 11 patients (61%), at least one cardiac or aortic source of emboli detected by TEE was missed by TTE. Significant carotid artery disease (>or=40% stenosis) was present in 3 of 16 patients (17%).
  
  
  CONCLUSIONS
  TEE is a potentially useful modality for detecting possible sources of retinal artery emboli and may be considered as an adjunct to the routine evaluation of affected patients.
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.forename: N
authors.initials: N
authors.lastname: Goldenberg-Cohen
authors.forename: Y
authors.initials: Y
authors.lastname: Shapira
authors.forename: R
authors.initials: R
authors.lastname: Axer-Siegel
authors.forename: H
authors.initials: H
authors.lastname: Shmuely
authors.forename: Y
authors.initials: Y
authors.lastname: Adler
authors.forename: D
authors.initials: D
authors.lastname: Weinberger
authors.forename: A
authors.initials: A
authors.lastname: Sagie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000000981:diagnostic imaging*; D012189:Retrospective Studies