Amaurosis Fugax Flashcards
What is it also referred to as?
What occurs here?
How does it differ to GCA?
➊ Retinal TIA, Transient CRAO
➋ Transient loss of vision due to hypoperfusion of the retina or optic nerve. Most commonly, an embolus from the carotid transiently occludes the central retinal, branch retinal, or ophthalmic artery.
N.B. Think of CRAO as a “Stroke of the eye” as there’s a permanent occlusion of the retinal artery (branch of the ophthalmic). Therefore, think of Amaurosis fugax as a “TIA if the eye”.
➌ GCA can cause a loss of vision. Although this is most commonly due to arteritis anterior ischaemic optic neuropathy (AAION), it can also be due to CRAO. This is why it’s important to rule out GCA in these pts as it shifts the management completely.
How is it investigated and managed?
- Detailed hx - Aim is to rule out GCA (e.g. headache, scalp tenderness, jaw claudication)
- Examination - Eye, temporal tenderness, cardiovascular, pulse, carotids
- Bloods - FBC, U&E, CRP, ESR
- Carotid ultrasound
- Urgent stroke work-up
N.B. Remember that, if GCA is suspected, then the patient needs to be started on high-dose steroid therapy i.e. Oral Prednisolone 60mg or IV Methylprednisolone.
