Neurovascular Causes of Acute Monocular Visual Loss

Melanie Truong-Le, Robert M. Mallery

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Article number27
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume22
Issue number10
DOIs
StatePublished - Sep 1 2020
Externally publishedYes

Keywords

  • Amaurosis fugax
  • Benign retinal vasospasm
  • Central Retinal Artery Occlusion (CRAO)
  • Giant cell arteritis
  • Ischemic optic neuropathy
  • Paracentral Acute Middle Maculopathy (PAMM)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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