Amaurosis fugax: is it innocuous?

A 10 year retrospective study of 103 patients with amaurosis fugax was done. Sixty-two patients with symptoms of amaurosis fugax underwent arteriography, which demonstrated ulcerated carotid plaque in 36 and hemodynamically significant stenoses (greater than 75% diameter reduction) in 26. These 62 patients underwent carotid endarterectomy. The other 41 patients who had proven ulcerated plaque (33 patients) or hemodynamic stenoses (eight patients) were not treated surgically and served as a control series. No strokes or deaths occurred in the immediate postoperative period. Follow-up of the 62 operated patients extending to 10 years (mean 4.2 years), revealed one (1.6%) patient with recurrent amaurosis fugax symptoms, two (3.2%) with transient ischemic attacks, and one (1.6%) with a stroke in the operated hemisphere. In the nonoperated group, despite aspirin or warfarin treatment, four (9.7%) patients had ongoing amaurosis fugax symptoms, and two (4.8%) developed transient ischemic attacks that led to carotid endarterectomy. One (2.4%) other patient developed sudden, permanent monocular blindness, and two (4.8%) suffered hemispheric strokes, one of which was fatal. The cumulative morbidity (ongoing ocular or transient ischemic attack symptoms, perioperative and late stroke) in the operated group was 6.4% (four patients), while the cumulative morbidity in the nonoperated group was significantly higher at 21.9% (nine patients) (p = 0.02). When patients present with symptoms of amaurosis fugax and have demonstrable carotid bifurcation disease, carotid endarterectomy is recommended. Amaurosis fugax should be regarded as a harbinger of monocular blindness and stroke.
AuthorsD Rosenthal, J C Hungerpiller, M E Crispin, M D Clark, P A Lamis, L L Pallos
JournalAnnals of vascular surgery (Ann Vasc Surg) Vol. 6 Issue 3 Pg. 281-8 (May 1992) ISSN: 0890-5096 [Print] UNITED STATES
PMID1610660 (Publication Type: Journal Article)
  • Adult
  • Aged
  • Aged, 80 and over
  • Blindness (etiology, therapy)
  • Carotid Stenosis (complications, surgery)
  • Cerebrovascular Disorders (etiology)
  • Endarterectomy, Carotid
  • Female
  • Humans
  • Ischemic Attack, Transient (etiology)
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: