Amaurosis fugax

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By Adrian Marchidann MD

Amaurosis fugax is also known as Transient monocular blindness. -ed.

Amaurosis fugax or transient vision loss is a symptom that raises concern for both patients and physicians because it may reflect a wide variety of pathologic processes, some of which may have important neurologic or ophthalmic consequences like stroke or blindness. The author reviews the current literature concerning the potential pathophysiologic mechanisms, diagnostic testing, and treatment strategies. In addition to noninvasive, accurate measurement of carotid artery stenosis, the identification of the vulnerable plaque at risk for rupture and stroke has aroused considerable interest. The prevention of stroke in patients with carotid steno-occlusive disease section was expanded as a reflection of the results of several completed clinical trials.

Key points

  • Amaurosis fugax is a clinical term, describing the occurrence of transient monocular or binocular visual loss due to retinal artery ischemia.
  • Vascular causes should be considered because if found, early treatment may reduce the risk of recurrent ischemia in appropriate patients
  • Detection of the vulnerable plaque will help better understanding, predict its behavior, and improve the risk stratification of carotid artery stenosis.
  • Venous abnormalities have been found in patients with amaurosis fugax without internal carotid artery atherosclerosis.
  • Stenting of symptomatic carotid artery stenosis has gained significant popularity over the past decade and rivals, in experienced hands, with carotid endarterectomy.
  • New oral anticoagulants have been approved for patients with nonvalvular atrial fibrillation. Their role continues to expand as the results of new trials become available.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited