Amaurosis Fugax: Diagnostic and Therapeutic Aspects

Abstract

The three to eight-year follow-up study of 34 patients with unilateral amaurosis fugax (AF) suggests the following points: (1) A significant number of frequent unilateral AF patients suffer from small ulcerative plaques or irregular stenoses without any bruit in the neck or major changes in ophthalmodynamometry (ODM). The most important diagnostic test in these cases is angiography. (2) Surgery in patients with frequent unilateral AF seems to be more successful than anticoagulation. (3) No treatment cannot be considered a policy of "benign neglect" and may result in serious complications. (4) Cholesterol plaques, carotid bruits, and abnormal ODM are suggestive of carotid artery disease in unilateral AF. However, the absence of these signs is not helpful in differentiating carotid artery from cardiac origin of the emboli. (5) Heart disease may be the main etiological factor in a few patients with AF. It plays a major role in mortality regardless of the type of treatment.