JKOS Journal of the Korean Ophthalmological Society J Korean Ophthalmol Soc 0378-6471 2092-9374 Korean Ophthalmological Society 10.3341/jkos.2016.57.9.1484 jkos-57-1484 Case Report Amaurosis Fugax Associated with Ipsilateral Internal Carotid Artery Agenesis SungJae Yun MD 1 KimKyoung Nam MD, PhD 1 JeongHye Seon MD, PhD 2 LeeYeon Hee MD, PhD 1 Department of Ophthalmology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea Address reprint requests to Kyoung Nam Kim, MD, PhD Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: 82-42-280-7600, Fax: 82-42-255-3745 E-mail: kkn9901700@hanmail.net 09 2016 25 09 2016 579 1484 1488 02062016 20072016 29082016 Copyright © 2016 Korean Ophthalmological Society 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

We report a case of amaurosis fugax associated with ipsilateral internal carotid artery agenesis.

 Case summary

A 50-year-old woman presented with amaurosis fugax in her left eye; the frequency of episodes of the condition had recently increased to once a month. She had a history of hypertension and dyslipidemia, and was under medical therapy. The visual acuity of both eyes was 20/20. Slit-lamp examination was normal except for pseudophakia. Ophthalmoscopy revealed a myopic tigroid fundus and a myopic tilted disc. No abnormalities were evident in fluorescein fundus angiography. Brain computed tomography showed that the left bony carotid canal was absent, and magnetic resonance angiography showed that the left internal carotid artery was also absent. She was diagnosed with left internal carotid artery agenesis. Other neurological and hematological parameters were within normal ranges. The amaurosis fugax spontaneously disappeared and has not recurred over the past 12 months. Our case, although rare, suggests that amaurosis fugax may be associated with internal carotid artery agenesis.

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Fundus photographs of the both eyes. Both eyes show myopic tigroid fundus and myopic tilted disc with peripapillary atrophy.

Fluorescein fundus angiography of the left eye. (A) Retinal artery filling was started at 10 seconds after injection of the sodium fluorescein dye into the antecubital vein. (B) Retinal vein filling was completed at 18 seconds after injection.

Magnetic resonance imaging (MRI) and computed tomography (CT). (A) MRI and (B) CT of the skull base showing a carotid canal on the right (arrows), but absent on the left.

Magnetic resonance angiography (MRA). (A) MRA reveals the right internal carotid artery (arrow) and the absence of the left internal carotid artery. (B) At the circle of Willis, the left middle cerebral artery and anterior cerebral artery (arrowheads) are filled via posterior communicating artery (arrow).