Clopidogrel effective for frequent transient monocular blindness caused by vulnerable plaque.

Abstract

Transient monocular blindness (TMB) is a well-known warning symptom of impending cerebral or retinal infarction, which suggests vulnerable ipsilateral carotid disease. Instability of free-floating thrombus may cause recurrent artery-to-artery embolism. A recent study showed that a combination of clopidogrel and aspirin might reduce microthromboembolisms. Here, we report a patient with frequent TMB despite aspirin monotherapy whose symptom disappeared after the addition of clopidogrel. This is the first report of aspirin-resistant frequent TMB caused by thromboembolism from vulnerable plaque that remitted after the addition of clopidogrel. These findings highlight the need for a randomized controlled trial to illustrate the most efficacious treatment strategy in this situation.

• Authors: Hong-Kyun Park, Hang Rai Kim, Beom Joon Kim, Jihoon Kang, Cheolkyu Jung, Byung Se Choi, Jae Hyoung Kim, Moon-Ku Han, Seong-Ho Park, Hee-Joon Bae
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 20 Issue 10 Pg. 1455-7 (Oct 2013) ISSN: 1532-2653 [Electronic] Scotland
• PMID: 23845263 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Platelet Aggregation Inhibitors
• Clopidogrel
• Ticlopidine

Topics

• Angiography, Digital Subtraction
• Blindness (drug therapy, etiology)
• Clopidogrel
• Humans
• Magnetic Resonance Angiography
• Male
• Middle Aged
• Plaque, Atherosclerotic (complications)
• Platelet Aggregation Inhibitors (therapeutic use)
• Ticlopidine (analogs & derivatives, therapeutic use)