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Ocular ischaemia due to a spontaneous carotid artery dissection
  1. Sara Frazão1,
  2. Catarina Perry da Câmara2,3,
  3. Rita Pinto Proença4 and
  4. Joana Tavares Ferreira3,4
  1. 1 Ophthalmology, Instituto de Oftalmologia Doutor Gama Pinto, Lisboa, Portugal
  2. 2 Neuroradiology, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
  3. 3 Nova Medical School/Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal
  4. 4 Ophthalmology, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal
  1. Correspondence to Dr Rita Pinto Proença, ritapintoproenca{at}


Internal carotid artery dissection (ICAD) is caused by the disruption of the tunica intima, with the formation of an intramural haematoma that can cause stenosis or occlusion of the artery’s lumen, leading to reduced blood flow and secondary thrombus formation. Up to two-thirds of patients with ICAD show ophthalmological symptoms or signs, which are, frequently, the first manifestations of this clinical condition, often preceding for weeks the neurological signs of cerebral infarction. Central retinal artery occlusion (CRAO) is a rare complication of ICAD, secondary either to haemodynamic compromise, with ocular hypoperfusion and reverse flow within the ophthalmic artery, or to thromboembolic events, in rarer cases. We report a case of CRAO secondary to a spontaneous ICAD, in an otherwise healthy middle-aged patient.

  • Ophthalmology
  • Retina
  • Neuroimaging
  • Neuroopthalmology
  • Stroke

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  • Contributors SF: evaluated the patient and wrote the draft of the case report. CPdC: chose the neurological images and described them, to be included in the text and images legends. RPP: contributed on literature search and revising the paper. JTF: evaluated the patient, and contributed on literature search and revising the paper. All authors approve the version that is been submitted.

  • Funding The authors have not a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.