Ophthalmodynamometric diagnosis of unilateral ischemic ophthalmopathy.

Abstract

To describe a patient presenting with typical signs of vascular occlusive retinopathy. Observational case report. A 65-year-old man experienced painless unilateral loss of vision to 4/20 in his left eye. Ophthalmoscopy of the left eye showed pronounced attenuation of the retinal arterioles, ischemic retinal edema, and a few intraretinal hemorrhages. Fluorescein angiography revealed a diffusely reduced retinal perfusion typical of retinal occlusive disease. Using a new ophthalmodynamometer with a pressure sensor at the mounting support of a conventional Goldmann contact lens, we additionally measured the diastolic central retinal artery collapse pressure. The diastolic central retinal artery collapse pressure was significantly lower in the left eye than in the right eye (14.7 +/- 2.4 relative units vs 51.7 +/- 4.3 relative units; P <.001). Both values were significantly (P =.03) lower than those in a control group (80.9 +/- 6.9 relative units). Doppler sonography revealed a total occlusion of the left carotid artery and a nonrelevant stenosis of the right carotid artery. A new ophthalmodynamometric device consisting of a pressure sensor at the mounting support of a Goldmann contact lens was helpful in detecting carotid artery occlusion leading to ischemic ophthalmopathy.