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Neurovascular Causes of Acute Monocular Visual Loss

  • Cerebrovascular Disease and Stroke (S Silverman, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Acute monocular visual loss may result from a diverse set of neurovascular and systemic disorders and requires urgent evaluation. The goal of this review is to describe the most current understanding of the clinical features, pathophysiology, diagnosis, and treatment of these disorders.

Recent findings

1. Acute central retinal artery occlusion (CRAO) should be treated as an equivalent to acute ischemic stroke.

2. Several recent clinical trials are evaluating the treatment of non-arteritic anterior ischemic optic neuropathy (NAION).

3. Tocilizumab is emerging as a first-line steroid-sparing immunomodulatory therapy for the treatment of giant cell arteritis (GCA).

4. Optical coherence tomography (OCT) imaging of the retina has led to the appreciation that retinal capillary ischemia in the form of paracentral acute middle maculopathy (PAMM) is a distinct form of acute monocular visual loss with relatively normal-appearing fundus examination and good prognosis for recovery.

Summary

Accurate diagnosis and timely treatment of disorders resulting in acute monocular visual loss may reduce the likelihood of additional visual and neurologic complications.

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Authors and Affiliations

  1. Department of Neurology, Brigham and Women’s Hospital, 60 Fenwood Rd, Boston, MA, 02115, USA

    Melanie Truong-Le DO, OD & Robert M. Mallery MD

  2. Department of Ophthalmology, Mass. Eye and Ear, Boston, MA, USA

    Melanie Truong-Le DO, OD & Robert M. Mallery MD

  3. Harvard Medical School, Boston, MA, USA

    Robert M. Mallery MD

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  1. Melanie Truong-Le DO, OD
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Correspondence to Robert M. Mallery MD.

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Truong-Le, M., Mallery, R.M. Neurovascular Causes of Acute Monocular Visual Loss. Curr Treat Options Cardio Med 22, 27 (2020). https://doi.org/10.1007/s11936-020-00829-7

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