Do complaints of amaurosis fugax and blurred vision after transcatheter device closure of atrial septal defect indicate microemboli to retinal vessels?
Atrial septal defect (ASD) is a common diagnosis in adults undergoing surgical repair. The aim of the study was to determine if ocular symptoms following treatment are due to microemboli. The study group included 20 adult patients (9 men, 11 women, mean age 57.2 years) with ASD who had undergone successful closure with the Amplatzer occluder. Patients were treated with aspirin or warfarin during the 6 months after the procedure. All were evaluated neurologically and an ocular medical history was obtained. Ocular examination included the 120-point Humphery visual field. Transcranial Doppler (TCD) was performed to monitor the middle cerebral artery. Two patients complained of amaurosis fugax at 1 and 3 months after the procedure, and two patients complained of blurred vision at 3 and 4 months after the procedure. TCD performed within 24 h of the complaints revealed no abnormalities. In all patients, the neurological and ocular examinations, including the visual field test, were normal. In conclusion, microembolic events do not appear to be the cause of the ocular complaints in patients with ASD treated with Amplatzer occluder. Further studies in larger samples are needed to confirm these results.
Ehrlich
Rita
R
Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tikva 49 100, Israel. ehrlichy@netvision.net.il
Mutzmacher
Larisa
L
Averbuch
Lea
L
Dotan
Gad
G
Hirsh
Refael
R
D000328:Adult; D000368:Aged; D020757:Amaurosis Fugax / Q000188:drug therapy / Q000209:etiology*; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000628:therapy; D002408:Catheters, Indwelling; D004452:Echocardiography; D004617:Embolism / Q000188:drug therapy / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012171:Retinal Vessels / Q000473:pathology*; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial; D015354:Vision, Low / Q000188:drug therapy / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014859:Warfarin; D001241:Aspirin