Korean J Ophthalmol.  2009 Mar;23(1):57-58. 10.3341/kjo.2009.23.1.57.

A Case of Carotid Aneurysm in Familial Retinal Arterial Tortuosity

Affiliations
  • 1Department of Ophthalmology, College of Medicine, and Medical Research Center, Seoul National University, Seoul, Korea. hgonyu@snu.ac.kr
  • 2Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.

Abstract

A 44-year-old woman who showed recurrent vitreous hemorrhages with vascular tortuosity received CT angiography which revealed an internal carotid artery aneurysm. A case of internal carotid aneurysm was associated with a pattern of retinal arteriolar tortuosity pathognomic for familial retinal arterial tortuosity (fRAT), suggesting possible involvement of the cerebral circulation. We present a case of internal carotid aneurysm associated with a pattern of retinal arteriolar tortuosity pathognomic for fRAT.

Keyword

Familial retinal arterial tortuosity (fRAT); Internal carotid artery aneurysm

MeSH Terms

Adult
Aneurysm/*complications/radiography
Angiography
Carotid Artery Diseases/*complications/radiography
*Carotid Artery, Internal
Diagnosis, Differential
Eye Abnormalities/complications/diagnosis/*genetics
Female
Follow-Up Studies
Humans
Retinal Artery/*abnormalities
Tomography, X-Ray Computed
Torsion Abnormality/complications/diagnosis/*genetics
Visual Acuity

Figure

  • Fig. 1 Fundus photography of subject with familial retinal arteriolar tortuosity. (A) Right eye. (B) Left eye. On the patient's first visit to the clinic with decreased visual acuity in the left eye, fundus examination showed marked tortuosity of the second- and third-order retinal arteries in both eyes as well as multiple preretinal hemorrhages in the left eye. (C) Right eye. (D) Left eye. Six months later, the patient noted decreased visual acuity in the right eye and fundus examination showed marked tortuosity of the second- and third- order retinal arteries in both eyes as well as multiple and preretinal hemorrhages in the right eye.

  • Fig. 2 Internal carotid artery aneurysm of patient with familial retinal arteriolar tortuosity. (A) A left internal carotid aneurysm was detected on CT angiography (white arrow). (B, C and D) The coiling of the aneurysm was performed through transfemoral cerebral angiography (white arrow).


Reference

1. Sears J, Gilman J, Sternberg P. Inherited retinal arteriolar tortuosity with retinal hemorrhage. Arch Ophthalmol. 1998. 116:1185–1188.
2. Bartlett WJ, Price J. Familial retinal arteriolar tortuosity with retinal hemorrhage. Am J Ophthalmol. 1983. 95:556–558.
3. Sutter FK, Helbig H. Familial retinal arteriolar tortuosity: A Review. Surv Ophthalmol. 2003. 48:245–255.
4. Gekeler F, Shinoda K, Junger M, et al. Familial retinal arterial tortuosity associated with tortousity in nail bed capillaries. Arch Ophthalmol. 2006. 124:1492–1494.
5. Longo GM, Kibbe MR. Aneurysms of the carotid artery. Semin Vasc Surg. 2005. 18:178–183.
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