What is the role of cardiac imaging studies in the workup of sudden visual loss?

Updated: Dec 11, 2019
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Noninvasive evaluation of the carotid artery and heart (eg, electrocardiography, echocardiography, carotid Doppler) is useful, particularly in older patients. This evaluation provides information on the degree of stenosis. Noninvasive study of the heart can detect abnormal valves, dyskinetic wall segments, and arrhythmias, all of which predispose to the formation of emboli.

However, angiography remains the diagnostic standard for detecting carotid atherosclerotic disease.

Fluorescein angiography is helpful in retinal vascular occlusive disease. The most common embolic particles are cholesterol crystals, which are often small; they disappear rapidly but not without damaging the vessel wall. Fluorescein angiography may show hyperfluorescent crystals or areas of fluorescein leakage that are caused by crystal-related endothelial damage.


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