Optical coherence tomography findings in a case of cilioretinal artery occlusion reversal,treated with mannitol and carbogen administration

To present spectral domain optical coherence tomography(OCT)findings during treatment in a case of acute isolated cilioretinal artery occlusion(CLRAO)reversed with intravenous systemic administration of mannitol and carbogen inhalation.Close monitoring with OCT thickness topographic map and cross section scans,every 12 hours,during treatment and till complete reversal of retinal nerve fiber layer edema.Fundus photography and fluorescein angiography(FFA)were used to illustrate occlusion and recanalization.After 72 hours of therapy,visual acuity improved from counting fingers(CF)to 7/10,Snellen’s chart.Consecutively OCT scans showed that the initial macular edema was gradually restored to typical 72 hours of treatment initiation.FFA performed after treatment confirmed recanalization of the cilioretinal artery.Early intervention with the combined intravenous administration of mannitol and carbogen inhalation can reverse acute onset loss of vision due to CLRAO.The reflectivity of retinal layers differs significantly regarding stages of acute CLRAO.In our case report increased reflectivity of the innermost layers of the retina was illustrated and a corresponding reduction in the outer retina and the retinal pigment epithelium and choriocapillaris layers.Macular thickness follow-up data recorded the course of intracellular edema to normal.

Incidence of cilioretinal arteries in Chinese Han population

AIM: To estimate the incidence of cilioretinal arteries among Han population of north China. METHODS: A cross-sectional sample of subjects aged from 20 years old to 80 years old were selected using a cluster sampling technique from Shenyang of Liaoning Province for Diabetic Eye Disease Study. Eligible subjects were recruited in the Community Health Center which took the stereo fundus photography using 45 degrees Non-Mydriatic Fundus Camera. Data were analyzed by SPSS 14.0. RESULTS: The incidence of cilioretinal arteries in 5000 eyes of 2500 subjects was determined. One, two or more cilioretinal arteries were present in 876 of all subjects and in 923 of all the eyes. Difference of presence, number and distribution of cilioretinal arteries was observed. During the subjects, the arteries occurred bilaterally in 6.9% and contributed to some portion of the temporal circulation in 78.3%, nasal circulation 14.8%, respectively. Statistical analysis indicated that there was no significant difference in incidence between men and women, left and right eyes (P>0.05). CONCLUSION: 35.0% persons have the cilioretinal arteries in Han population of north China. Men and women have an equal distribution of cilioretinal arteries.

针刺联合血府逐瘀汤治疗睫状视网膜动脉阻塞1例

The report presented a case of cilioretinal artery occlusion. A 22-year-old woman, with a complain of reduced visual acuity of the right eye for 4 days, presented with blurred vision and inferior visual field defect at the time of visit. Acupuncture combined with herbal medication of Xuefu Zhuyu Decoction was applied for the patient. Main acupoints included Jingming (BL1), Qiuhou (EX-HN7), Sizhukong (TE23), Yuyao (EX-HN3), Sibai (ST2), Fengchi (GB20), Hegu (LI4), Guangming (GB37) and Taichong (LR3). The needles were remained for 30 min in each session, which was given once daily for 10 days. The modified Xuefu Zhuyu Decoction (Semen Juglandis [10 g], Flos Carthami [10 g], Rhizoma Chuanxiong [10 g], Radix Paeoniae Rubra [10 g], Radix Rehmanniae [15 g], Radix Angelicae Sinensis [10 g], Radix Bupleuri [10 g], Fructus Aurantii [5 g], Radix et Rhizoma Glycyrrhizae Praeparata cum Melle [6 g], Fructus Crataegi [20 g], Endothelium Corneum Gigeriae Galli [10 g], Scorpio [5 g], Herba Leonuri [15 g], Radix Astragali [35 g] and Ramulus Cinnamomi [10 g]) was applied one dose daily for 7 days. After 7 days of treatment, the visual acuity of the patient was increased from 0.04 to 0.6 in the right eye with spectacles, the retinal fundus edema disappeared and the inferior vision field defect relieved. With acupuncture treatment for another 10 days, it was observed that the visual acuity of the patient's right eye was improved and the inferior vision field defect reduced. There was no symptom recurrence and the visual acuities in both eyes of the patient were 1.0 with spectacles till the latest follow-up. This therapy provided a new idea and approach to treat cilioretinal artery occlusion.