Painless bilateral visual loss in a 33-year-old woman with severe arterial hypotension.

Abstract:

:A 32-year-old woman experienced dizziness and headache for 5 months. She also complained of painless, progressive bilateral visual loss for several weeks. Before developing the initial symptoms, she had an uncomplicated pregnancy except for dizziness and systemic hypotension during the first term. Fundus examination disclosed prominent retinal arteries as well diffuse microaneurysms, widespread intraretinal hemorrhages, and hyperemic optic disks. Brain magnetic resonance imaging revealed multiple supratentorial white-matter lesions suggestive of ischemic strokes. Initially, she had severe systemic hypotension (41/17 mm Hg). When reassessed, blood pressure was normal in the lower limbs, but there was severe hypotension in the upper limbs. An angio-computed tomography of the supraortic trunks showed occlusion of both primitive carotid arteries, both subclavian arteries and the right axillary and humeral arteries. Based on these findings, the diagnosis of Takayasu type-I arteritis with ischemic retinopathy and cerebrovascular disease was established. Bilateral retinal panphotocoagulation and aorta to right carotid bypass were performed because of the severity of the ischemic lesions.

journal_name

Surv Ophthalmol

journal_title

Survey of ophthalmology

authors

Subirà O,Muñoz S,Sánchez JJ,Puyalto P,Lee AG

doi

10.1016/j.survophthal.2017.03.001

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

125-131

issue

1

eissn

0039-6257

issn

1879-3304

pii

S0039-6257(17)30051-6

journal_volume

63

pub_type

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