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Cet abstract a été assigné à session OBAO: Organisatie van Belgische Assistenten in Oftalmologie/Organisation Belge des Assistants en Ophtalmologie
TitreTransient visual loss
ButHow do I manage a Transient Monocular Visual Loss in a young patient ?
The differential diagnosis of TMVL in young patient includes a number of entities . "Vasospasm" (retinal migraine), a frequent condition, often affects the same eye every time, has a very stereotypic pattern, no scintillations, no neurological anomalies. This is a diagnosis of exclusion. Selected patients will have specific testing to exclude heart disease, carotid dissection or dysplasia, hypercoagulable/hyperviscosity syndromes. Historical clues are important, and complete examination is necessary.

How do I manage a Transient Monocular Visual Loss in an older patient ?
An aggressive work-up is mandatory. Ischemia is the main problem : carotid artery stenosis, carotid or cardiac emboles and Horton disease. The patient is at risk for stroke. Mortality is increased resulting more likely from myocardial infarction than from stroke.
Carotid endarterectomy is warranted for symptomatic patients with greater than 50% stenosis, and asymptomatic patients with greater than 60%. Newer surgical alternatives (angioplasty and stenting) are proposed. Medical treatments include anti-platelets such as aspirin and clopidogrel (Plavix) are used.
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