Recurrent retinal artery ischemia as a presenting symptom of ophthalmic artery aneurysm

Abstract

An 81 years old woman presented with sudden painless greying of her vision in the right eye. This resolved within l-2 hours without any residual visual loss. She experienced similar symptoms twice in 4 months. The attacks lasted forty to sixty minutes. She had no history of hypertension, diabetes mellitus, migraine, ischemic heart disease and atrial fibrillation. Further neurological and systemic enquiry was negative On ocular examination, best visual acuity was 6/9 right eye and 6/60 in left eye. Slit lamp biomicroscopy, tonometry and discs appearances were normal. Right macula showed multiple drusens and dry type of ARMD.There was left disciform macular degeneration. The vascular pattern of both fundi was normal and did not reveal any embolus. Extraocular movements were normal. Cardiovascular examination, Carotid artery palpation and auscultation were all normal. Serum cholesterol level was normal. Thrombophilic screen was negative. Magnetic Resonance Angiogram showed aneurysm of right ophthalmic artery near the junction of carotid-ophthalmic artery. After neurosurgical consultation, she was advised to take Tab. Aspirin 75mg daily.