Korean J Ophthalmol.  2012 Apr;26(2):132-134. 10.3341/kjo.2012.26.2.132.

A Case of Central Retinal Artery Occlusion after Chiropractic Manipulation of the Neck

• Jang YJ
• Chun JW
• Lee SW
• Kim HC

• KMID: 1364867
• DOI: http://doi.org/10.3341/kjo.2012.26.2.132

Abstract

Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiropractor eight days prior. When he first visited us, his best corrected visual acuity in his right eye was hand motion. A full ophthalmic examination was performed. There was cherry-red spot in the macula in his right eye. We performed a fluorescein angiogram and cervical color Doppler. The arterio-venous transit time in the fluorescein angiogram was delayed, and we detected stenosis of the right internal carotid artery with diffuse atherosclerotic plaques in the right common carotid artery. We prescribed ginko biloba extract (Tanamin). Three years after his first visit, the best corrected visual acuity of his right eye was 20 / 200.

Keyword

Chiropractic manipulation; Retinal artery occlusion

MeSH Terms

Carotid Artery Diseases/ultrasonography
Fluorescein Angiography
Humans
Male
Manipulation, Chiropractic/*adverse effects
Middle Aged
Neck/blood supply
Retinal Artery Occlusion/diagnosis/*etiology
Vision Disorders/diagnosis/*etiology

Figure

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  Fig. 1 Fundus photograph of the right eye showed whitening and opacification of the retina with a cherry-red spot in the fovea.

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  Fig. 2 The fluorescein angiogram indicated that the right retinal artery was still poorly filled, 35.0 second after injection.

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  Fig. 3 Cervical color Doppler showed that the right internal carotid artery (A) was narrower than the left internal carotid artery (B). ICA = internal carotid artery; ECA = external carotid artery.

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  Fig. 4 Cervical color Doppler showed diffuse atherosclerotic plaques in the right common carotid artery (A) and stenosis of the right internal carotid artery (B). RT = right; ICA = internal carotid artery.

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  Fig. 5 The right anterior communication artery was not visible by magnetic resonance angiography.

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