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Anterior Segment Ischemia

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Ocular Vascular Occlusive Disorders
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Abstract

Anterior segment ischemia is not a common disorder but it can result in serious visual loss. In this condition, there is usually ischemia of the iris and ciliary body but it may involve the cornea and sclera. The blood supply of the anterior segment is discussed at length in Chap. 6.

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References

  1. Schmidt H. Beitrag zur Kenntniss der Embolie der Arteria centralis retinae. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1874;20:287–307.

    Google Scholar 

  2. Crock G. Clinical syndromes of anterior segment ischaemia. Trans Ophthalmol Soc U K. 1967;87:513–33.

    CAS  PubMed  Google Scholar 

  3. Harbitz F. Bilateral carotid arteritis. Arch Pathol Lab Med. 1926;1:499–510.

    Google Scholar 

  4. Leinfelder PJ, Black NM. Experimental transposition of the extraocular muscles in monkeys. Am J Ophthalmol. 1941;24(10):1115–9.

    Google Scholar 

  5. Skipper E, Flint FJ. Symmetrical arterial occlusion of upper extremities head, and neck: a rare syndrome. Br Med J. 1952;2(4774):9–14.

    PubMed Central  CAS  PubMed  Google Scholar 

  6. Ask-Upmark E. On the pulseless disease outside of Japan. Acta Med Scand. 1954;149(3):161–78.

    CAS  PubMed  Google Scholar 

  7. Knox DL. Ischemic ocular inflammation. Am J Ophthalmol. 1965;60(6):995–1002.

    CAS  PubMed  Google Scholar 

  8. Wilson WA, Irvine SR. Pathologic changes following disruption of blood supply to iris and ciliary body. Trans Am Acad Ophthalmol Otolaryngol. 1955;59(4):501–2.

    CAS  PubMed  Google Scholar 

  9. Loring EG. Remarks on embolism. Am J Med Sci. 1974;67:313–28.

    Google Scholar 

  10. Smith JL. Unilateral glaucoma in carotid occlusive disease. JAMA. 1962;182:683–4.

    CAS  PubMed  Google Scholar 

  11. Hoefnagels KL. Rubeosis of the iris associated with occlusion of the carotid artery. Ophthalmologica. 1964;148:196–200.

    CAS  PubMed  Google Scholar 

  12. Hart CT, Haworth S. Bilateral common carotid occlusion with hypoxic ocular sequelae. Br J Ophthalmol. 1971;55(6):383–8.

    PubMed Central  CAS  PubMed  Google Scholar 

  13. Michelson PE, Knox DL, Green WR. Ischemic ocular inflammation. A clinicopathologic case report. Arch Ophthalmol. 1971;86(3):274–80.

    CAS  PubMed  Google Scholar 

  14. Anderson DM, Morin JD, Hunter WS. Rubeosis iridis. Can J Ophthalmol. 1971;6(3):183–8.

    CAS  PubMed  Google Scholar 

  15. Huckman MS, Haas J. Reversed flow through the ophthalmic artery as a cause of rubeosis iridis. Am J Ophthalmol. 1972;74(6):1094–9.

    CAS  PubMed  Google Scholar 

  16. Makabe R. A peculiar neovascularisation glaucoma after occlusion of the internal carotid (author’s transl). Klin Monbl Augenheilkd. 1974;164(5):700–4.

    CAS  PubMed  Google Scholar 

  17. Appen RE, Wray SH, Cogan DG. Central retinal artery occlusion. Am J Ophthalmol. 1975;79(3):374–81.

    CAS  PubMed  Google Scholar 

  18. Nisikawa N, Fukuda M, Shimuzu Y, Tsukamoto H, Bessho T, Taniguchi H, et al. Rubeotic glaucoma secondary to internal carotid artery occlusion. Nihon Ganka Kiyo. 1977;28:841–6.

    Google Scholar 

  19. Willerson D, Aaberg TM. Acute central retinal artery occlusion and optic disc neovascularization: occurrence in a patient with carotid eye disease. Arch Ophthalmol. 1978;96:451–2.

    Google Scholar 

  20. Henkind P. Ocular neovascularization. The Krill Memorial Lecture. Am J Ophthalmol. 1978;85(3):287–301.

    Google Scholar 

  21. Gartner S, Henkind P. Neovascularization of the iris (rubeosis iridis). Surv Ophthalmol. 1978;22(5):291–312.

    CAS  PubMed  Google Scholar 

  22. Eggleston TF, Bohling CA, Eggleston HC, Hershey FB. Photocoagulation for ocular ischemia associated with carotid artery occlusion. Ann Ophthalmol. 1980;12(1):84–7.

    Google Scholar 

  23. Young LH, Appen RE. Ischemic oculopathy. A manifestation of carotid artery disease. Arch Neurol. 1981;38(6):358–61.

    Google Scholar 

  24. Brown GC, Magargal LE, Simeone FA, Goldberg RE, Federman JL, Benson WE. Arterial obstruction and ocular neovascularization. Ophthalmology. 1982;89(2):139–46.

    CAS  PubMed  Google Scholar 

  25. Hayreh SS, Podhajsky P. Ocular neovascularization with retinal vascular occlusion. II. Occurrence in central and branch retinal artery occlusion. Arch Ophthalmol. 1982;100(10):1585–96.

    CAS  PubMed  Google Scholar 

  26. Kiser WD, Gonder J, Magargal LE, Sanborn GE, Simeone F. Recovery of vision following treatment of the ocular ischemic syndrome. Ann Ophthalmol. 1983;15(4):305–10.

    CAS  PubMed  Google Scholar 

  27. Cowan Jr CL, Butler G. Ischemic oculopathy. Ann Ophthalmol. 1983;15(11):1052–7.

    PubMed  Google Scholar 

  28. Higgins RA. Neovascular glaucoma associated with ocular hypoperfusion secondary to carotid artery disease. Aust J Ophthalmol. 1984;12(2):155–62.

    CAS  PubMed  Google Scholar 

  29. Sturrock GD, Mueller HR. Chronic ocular ischaemia. Br J Ophthalmol. 1984;68(10):716–23.

    PubMed Central  CAS  PubMed  Google Scholar 

  30. Brown GC. Anterior ischemic optic neuropathy occurring in association with carotid artery obstruction. J Clin Neuroophthalmol. 1986;6(1):39–42.

    CAS  PubMed  Google Scholar 

  31. Kahn M, Green WR, Knox DL, Miller NR. Ocular features of carotid occlusive disease. Retina. 1986;6(4):239–52.

    CAS  PubMed  Google Scholar 

  32. Ros MA, Magargal LE, Hedges Jr TR, Simeone FA. Ocular ischemic syndrome: long-term ocular complications. Ann Ophthalmol. 1987;19(7):270–2.

    CAS  PubMed  Google Scholar 

  33. Johnston ME, Gonder JR, Canny CL. Successful treatment of the ocular ischemic syndrome with panretinal photocoagulation and cerebrovascular surgery. Can J Ophthalmol. 1988;23(3):114–9.

    CAS  PubMed  Google Scholar 

  34. Sivalingam A, Brown GC, Magargal LE, Menduke H. The ocular ischemic syndrome. II. Mortality and systemic morbidity. Int Ophthalmol. 1989;13(3):187–91.

    CAS  PubMed  Google Scholar 

  35. Sivalingam A, Brown GC, Magargal LE. The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment. Int Ophthalmol. 1991;15(1):15–20.

    CAS  PubMed  Google Scholar 

  36. Jacobs NA, Trew DR. Occlusion of the central retinal artery and ocular neovascularisation: an indirect association? Eye (Lond). 1992;6(Pt 6):599–602.

    Google Scholar 

  37. Mizener JB, Podhajsky P, Hayreh SS. Ocular ischemic syndrome. Ophthalmology. 1997;104(5):859–64.

    CAS  PubMed  Google Scholar 

  38. Stucchi C, Bianchi G. Depigmentation in the iris sector following muscle transplantations. Ophthalmologica. 1957;133(4–5):231–6.

    CAS  PubMed  Google Scholar 

  39. Forbes SB. Muscle transplantation for external rectus paralysis; report of case with unusual complications. Am J Ophthalmol. 1959;48(2):248–51.

    CAS  PubMed  Google Scholar 

  40. Girard LJ, Beltranena F. Early and late complications of extensive muscle surgery. Arch Ophthalmol. 1960;64:576–84.

    CAS  PubMed  Google Scholar 

  41. Audoueineix E. Segmental atrophy of the iris after the Hummelsheim-O’Connor operation. Bull Soc Ophtalmol Fr. 1960;10:638–42.

    CAS  PubMed  Google Scholar 

  42. Uribe LE. Muscle transplantation in ocular paralysis. Am J Ophthalmol. 1968;65(4):600–7.

    CAS  PubMed  Google Scholar 

  43. Fells P. Vertical rectus muscle transplantation to restore abduction. In: Mein J, Bierlaagh JJM, Brummelkamp-Dons TEA, editors. Proceedings of the Second International Orthoptic Congress, 1971. Amsterdam: Excerpta Medica; 1972. p. 229–37.

    Google Scholar 

  44. Easty DL, Chignell AH. Fluorescein angiography in anterior segment ischaemia. Br J Ophthalmol. 1973;57(1):18–26.

    PubMed Central  CAS  PubMed  Google Scholar 

  45. von Noorden GK. Anterior segment ischemia following the Jensen procedure. Arch Ophthalmol. 1976;94(5):845–7.

    Google Scholar 

  46. Jacobs DS, Vastine DW, Urist MJ. Anterior segment ischemia and sector iris atrophy: after strabismus surgery in a patient with chronic lymphocytic leukemia. Ophthalmic Surg. 1976;7(4):42–8.

    CAS  PubMed  Google Scholar 

  47. Hiatt RL. Production of anterior segment ischemia. J Pediatr Ophthalmol Strabismus. 1978;15(4):197–204.

    CAS  PubMed  Google Scholar 

  48. Hayreh SS, Scott WE. Fluorescein iris angiography. II. Disturbances in iris circulation following strabismus operation on the various recti. Arch Ophthalmol. 1978;96(8):1390–400.

    CAS  PubMed  Google Scholar 

  49. Fells P. Anterior segment ischaemia. Lens changes after strabismus surgery. Trans Ophthalmol Soc U K. 1980;100(3):398–9.

    CAS  PubMed  Google Scholar 

  50. Saunders RA, Sandall GS. Anterior segment ischemia syndrome following rectus muscle transposition. Am J Ophthalmol. 1982;93(1):34–8.

    CAS  PubMed  Google Scholar 

  51. Virdi PS, Hayreh SS. Anterior segment ischemia after recession of various recti. An experimental study. Ophthalmology. 1987;94(10):1258–71.

    CAS  PubMed  Google Scholar 

  52. Ohtsuki H, Hosoda A, Hasebe S, Furuse T, Tanaka T, Matsuo N. Microvascular change of the anterior eye segment after tenotomy in the rabbit. Graefes Arch Clin Exp Ophthalmol. 1997;235(6):393–8.

    CAS  PubMed  Google Scholar 

  53. Borley WE, Snyder AA. Surgical treatment of high myopia; the combined lamellar scleral resection with scleral reinforcement using donor eye. Trans Am Acad Ophthalmol Otolaryngol. 1958;62(6):791–802.

    CAS  PubMed  Google Scholar 

  54. Boniuk M, Zimmerman LE. Necrosis of the iris, ciliary body, lens and retina following scleral buckling operations with circling polyethylene tubes. Trans Am Acad Ophthalmol Otolaryngol. 1961;65:671–93.

    CAS  PubMed  Google Scholar 

  55. Boniuk M, Zimmerman LE. Necrosis of uvea, sclera, and retina following operations for retinal detachment surgery. Arch Ophthalmol. 1961;66:318–26.

    Google Scholar 

  56. Boniuk M, Zimmerman LE, Boniuk M, Zimmerman LE. Pathological anatomy of complications. In: Schepens CL, Regan CDJ, editors. Controversial aspects of the management of retinal detachment. Boston: Little Brown & Co; 1965. p. 263–87.

    Google Scholar 

  57. Shea M. Complications common to all surgical procedures. In: Schepens CL, Regan CDJ, editors. Controversial aspects of the management of retinal detachment. Boston: Little Brown & Co; 1965. p. 207–15.

    Google Scholar 

  58. Duguid IM. Anterior segment necrosis following retinal detachment surgery. Trans Ophthalmol Soc U K. 1967;87:171–8.

    CAS  PubMed  Google Scholar 

  59. Ryan SJ, Goldberg MF. Anterior segment ischemia following scleral buckling in sickle cell hemoglobinopathy. Am J Ophthalmol. 1971;72(1):35–50.

    CAS  PubMed  Google Scholar 

  60. Eagle Jr RC, Yanoff M, Morse PH. Anterior segment necrosis following scleral buckling in hemoglobin SC disease. Am J Ophthalmol. 1973;75(3):426–33.

    PubMed  Google Scholar 

  61. Robertson DM. Anterior segment ischemia after segmental episcleral buckling and cryopexy. Am J Ophthalmol. 1975;79(5):871–4.

    CAS  PubMed  Google Scholar 

  62. Lincoff H, Ramirez V, Kreissig I, Baronberg N, Kaufman D. Encircling operations without drainage of subretinal fluid. Mod Probl Ophthalmol. 1975;15:188–96.

    CAS  PubMed  Google Scholar 

  63. Lincoff H, Kreissig I, Parver L. Limits of constriction in the treatment of retinal detachment. Arch Ophthalmol. 1976;94(9):1473–7.

    CAS  PubMed  Google Scholar 

  64. Mester U, Kreissig I. Signs of anterior segment ischemia following segmental external buckling (author’s transl). Klin Monbl Augenheilkd. 1979;175(2):240–2.

    CAS  PubMed  Google Scholar 

  65. Landblad Y. Temporal arteritis complicated by iritis. Nord Med. 1956;56:1794.

    Google Scholar 

  66. Zion VM, Goodside V. Anterior segment ischemia with ischemic optic neuropathy. Surv Ophthalmol. 1974;19(1):19–30.

    CAS  PubMed  Google Scholar 

  67. Hayreh SS. Anterior ischaemic optic neuropathy. Heidelberg: Springer; 1975. p. 93.

    Google Scholar 

  68. Verdich M, Nielsen NV. Acute transient ophthalmomalacia in giant-cell arteritis. Report of a case. Acta Ophthalmol (Copenh). 1975;53(6):875–8.

    CAS  Google Scholar 

  69. Watson PG, Hazleman BL. The sclera and systemic disorders. Philadelphia: W.B. Saunders; 1976. p. 274.

    Google Scholar 

  70. Winter BJ, Cryer TH, Hameroff SB. Anterior segment ischemia in temporal arteritis. South Med J. 1977;70(12):1479–81.

    CAS  PubMed  Google Scholar 

  71. Gerstle CC, Friedman AH. Marginal corneal ulceration (limbal guttering) as a presenting sign of temporal arteritis. Ophthalmology. 1980;87(11):1173–6.

    CAS  PubMed  Google Scholar 

  72. Radda TM, Bardach H, Riss B. Acute ocular hypotony. A rare complication of temporal arteritis. Ophthalmologica. 1981;182(3):148–52.

    CAS  PubMed  Google Scholar 

  73. Hayreh SS. Ophthalmic features of giant cell arteritis. Baillieres Clin Rheumatol. 1991;5(3):431–59.

    CAS  PubMed  Google Scholar 

  74. Hayreh SS, Podhajsky PA, Zimmerman B. Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998;125(4):509–20.

    CAS  PubMed  Google Scholar 

  75. Krupin T, Johnson MF, Becker B. Anterior segment ischemia after cyclocryotherapy. Am J Ophthalmol. 1977;84(3):426–8.

    CAS  PubMed  Google Scholar 

  76. Sharp DC, Bell RA, Cruess AF. Anterior segment necrosis following cyclocryotherapy. Can J Ophthalmol. 1982;17(6):268–70.

    CAS  PubMed  Google Scholar 

  77. Galinos S, Rabb MF, Goldberg MF, Frenkel M. Hemoglobin SC disease and iris atrophy. Am J Ophthalmol. 1973;75(3):421–5.

    CAS  PubMed  Google Scholar 

  78. Cullis CM, Hines DR, Bullock JD. Anterior segment ischemia: classification and description in chronic myelogenous leukemia. Ann Ophthalmol. 1979;11(11):1739–44.

    CAS  PubMed  Google Scholar 

  79. Kottow M, Wassilewa P, Hendrickson P. Provoked iris ischaemia in the rabbit: a fluorescein angiographic study. Can J Ophthalmol. 1975;10(2):255–62.

    CAS  PubMed  Google Scholar 

  80. Raitta C. The significance of ciliary circulation in the development of iris neovascularisation (author’s transl). Klin Monbl Augenheilkd. 1980;177(3):354–61.

    CAS  PubMed  Google Scholar 

  81. Okada H, Sano T, Yoneda M, Miki H. Development of corneal neovascularization following the occlusion of the posterior long ciliary arteries. Nihon Ganka Gakkai Zasshi. 1983;87(11):1175–86.

    CAS  PubMed  Google Scholar 

  82. Berger BB, Tessler HH, Kottow MH. Anterior segment ischemia in Fuchs’ heterochromic cyclitis. Arch Ophthalmol. 1980;98(3):499–501.

    CAS  PubMed  Google Scholar 

  83. Friedman AH, Bloch R, Henkind P. Hypopyon and iris necrosis in angle-closure glaucoma. Report of two cases. Br J Ophthalmol. 1972;56(8):632–5.

    PubMed Central  CAS  PubMed  Google Scholar 

  84. Sugar HS, Okamura ID. Ocular findings six years after intravitreal silicone injection. Arch Ophthalmol. 1976;94(4):612–5.

    CAS  PubMed  Google Scholar 

  85. Anderson B, Anderson Jr B. Necrotizing uveitis incident to perfusion of intractraial malignancies with nitrogen mustard or related compounds. Trans Am Ophthalmol Soc. 1960;58:95–104.

    PubMed Central  CAS  PubMed  Google Scholar 

  86. Van Buskirk EM. The ciliary vasculature and its perturbation with drugs and surgery. Trans Am Ophthalmol Soc. 1988;86:794–841.

    PubMed Central  PubMed  Google Scholar 

  87. Morrison JC, Van Buskirk EM. Anterior collateral circulation in the primate eye. Ophthalmology. 1983;90(6):707–15.

    CAS  PubMed  Google Scholar 

  88. Hayreh SS, Baines JA. Occlusion of the posterior ciliary artery. I. Effects on choroidal circulation. Br J Ophthalmol. 1972;56(10):719–35.

    PubMed Central  CAS  PubMed  Google Scholar 

  89. Hayreh SS, Baines JA. Occlusion of the posterior ciliary artery. II. Chorio-retinal lesions. Br J Ophthalmol. 1972;56(10):736–53.

    PubMed Central  CAS  PubMed  Google Scholar 

  90. Hayreh SS, Chopdar A. Occlusion of the posterior ciliary artery. V. Protective influence of simultaneous vortex vein occlusion. Arch Ophthalmol. 1982;100(9):1481–91.

    CAS  PubMed  Google Scholar 

  91. Hayreh SS. The long posterior ciliary arteries. An experimental study. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1974;192(3):197–213.

    Google Scholar 

  92. Hayreh SS. Segmental nature of the choroidal vasculature. Br J Ophthalmol. 1975;59(11):631–48.

    PubMed Central  CAS  PubMed  Google Scholar 

  93. Hayreh SS. Physiological anatomy of the choroidal vascular bed. Int Ophthalmol. 1983;6(2):85–93.

    CAS  PubMed  Google Scholar 

  94. Hayreh SS. Inter-individual variation in blood supply of the optic nerve head. Its importance in various ischemic disorders of the optic nerve head, and glaucoma, low-tension glaucoma and allied disorders. Doc Ophthalmol. 1985;59(3):217–46.

    CAS  PubMed  Google Scholar 

  95. Hayreh SS, Baines JA. Occlusion of the vortex veins. An experimental study. Br J Ophthalmol. 1973;57(4):217–38.

    PubMed Central  CAS  PubMed  Google Scholar 

  96. Wagenmann A. Experimental investigation of the influence of the circulation within the retina and choroid for the nourishment of the eye, especially the retina, and about the consequences of optic nerve transection. Albrecht von Graefes Arch Ophthalmol. 1890;36(4):1–120.

    Google Scholar 

  97. Bossalino D. Ricerche sperimentali sulle alterazioni dell’occhio consecutive al taglio dei vasi ciliari. Annali di ottalmologia. 1910;39:866–914.

    Google Scholar 

  98. Favaloro G. Sulla peritomia ignea profonda nell’occhio umano ed animale e sulle sue possibili applicazioni in terapia oculare, specie antiipertensiva. Lettura Oftalmol. 1927;4:75–99.

    Google Scholar 

  99. Guerry D. Angiodiathermy of the long posterior ciliary arteries and its use in the treatment of glaucoma. Am J Ophthalmol. 1944;27(12):1376–93.

    Google Scholar 

  100. Freeman HM, Hawkins WR, Schepens CL. Anterior segment necrosis. An experimental study. Arch Ophthalmol. 1966;75(5):644–50.

    CAS  PubMed  Google Scholar 

  101. Schulze RR. Rubeosis iridis. Am J Ophthalmol. 1967;63(3):487–95.

    CAS  PubMed  Google Scholar 

  102. Anderson DM, Morin JD. Experimental anterior segment necrosis and rubeosis iridis. Can J Ophthalmol. 1971;6(3):196–201.

    CAS  PubMed  Google Scholar 

  103. Kottow MH, DeLeon J. Experimental rubeosis of the iris in rabbits. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1978;209(1):11–8.

    Google Scholar 

  104. Prince JH. The rabbit in eye research. Springfield: Charles C. Thomas; 1964. p. 531, 539–40.

    Google Scholar 

  105. Jensen CD. Rectus muscle union: a new operation for paralysis of the rectus muscles. Trans Pac Coast Otoophthalmol Soc Annu Meet. 1964;45:359–87.

    CAS  PubMed  Google Scholar 

  106. Hummelsheim E. Weitere Erfahrungen mit partieller Sehnenüberpflanzung an den Augenmuskeln. Arch Augenheilkd. 1908;62:71–4.

    Google Scholar 

  107. Hayreh SS, Scott WE. Fluorescein iris angiography. I. Normal pattern. Arch Ophthalmol. 1978;96(8):1383–9.

    CAS  PubMed  Google Scholar 

  108. Henkind P. Angle vessels in normal eyes. A gonioscopic evaluation and anatomic correlation. Br J Ophthalmol. 1964;48:551–7.

    PubMed Central  CAS  PubMed  Google Scholar 

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Hayreh, S.S. (2015). Anterior Segment Ischemia. In: Ocular Vascular Occlusive Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-12781-1_20

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