Amaurosis Fugax Associated with Ipsilateral Internal Carotid Artery Agenesis

Jae Yun Sung; Kyoung Nam Kim; Hye Seon Jeong; Yeon Hee Lee

doi:10.3341/jkos.2016.57.9.1484

Journal List > J Korean Ophthalmol Soc > v.57(9) > 1010408

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Sung, Kim, Jeong, and Lee: Amaurosis Fugax Associated with Ipsilateral Internal Carotid Artery Agenesis

Case Report

J Korean Ophthalmol Soc 2016;57(9):1484-1488.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.9.1484

Amaurosis Fugax Associated with Ipsilateral Internal Carotid Artery Agenesis

Jae Yun Sung, MD¹, Kyoung Nam Kim, MD, PhD¹, Hye Seon Jeong, MD, PhD², Yeon Hee Lee, MD, PhD¹

¹Department of Ophthalmology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

²Department 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

Received 2 June 2016 Revised 20 July 2016 Accepted 29 August 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.

Keywords: Agenesis, Amaurosis fugax, Internal carotid artery

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Figure 1.

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

Figure 2.

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.

Figure 3.

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.

Figure 4.

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).

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