Reflux of jugular and retrobulbar venous flow in transient monocular blindness

Hung Yi Hsu, A. Ching Chao, Yen Yu Chen, Fu Yi Yang, Chih Ping Chung, Wen Yung Sheng, May Yung Yen, Han Hwa Hu

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Abstract

Objective: Transient monocular blindness (TMB) attacks may occur during straining activities that impede cerebral venous return. Disturbance of cerebral and orbital venous circulation may be involved in TMB. Methods: Duplex ultrasonography and Doppler-flow measurement of jugular and retrobulbar veins were performed in 134 consecutive patients with TMB and 134 age- and sex-matched control subjects. All recruited patients received thorough examinations to screen for possible underlying causes. Results: Of the 134 patients with TMB, 48 patients had ipsilateral carotid arterial lesion and 7 patients had TMB attack(s) caused by cardiac embolism. Of the remaining 79 patients with undetermined cause, 46 had 3 or more TMB attacks (undetermined-frequent group) and 33 had fewer than 3 attacks. In comparison with the control subjects, the TMB patients had greater frequencies of jugular venous reflux (57 vs 30%; p < 0.0001; odds ratio [OR]: 3.079, 95% confidence intervals [CI]: 1.861-5.096) and flow reversal in the superior ophthalmic vein (RSOV; 37 vs 9%; p < 0.0001; OR: 6.052, CI: 3.040-12.048). The undetermined-frequent group had the greatest frequencies of jugular venous reflux (74%, 34 patients; OR: 6.66, CI: 3.13-14.17) and RSOV (59%, 27 patients; OR: 6.51, CI: 3.12-13.58). Of the 50 patients with RSOV, 47 (94%) had RSOV on the side of the TMB attacks. Interpretation: The increased incidences of jugular and orbital venous reflux in TMB patients suggest that disturbance of cerebral and orbital venous circulation is involved in the pathogenesis of TMB, especially among patients with frequent attacks of undetermined cause.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalAnnals of Neurology
Volume63
Issue number2
DOIs
Publication statusPublished - Feb 1 2008
Externally publishedYes

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Amaurosis Fugax
Neck
Odds Ratio
Confidence Intervals
Doppler Duplex Ultrasonography
Jugular Veins
Embolism

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Hsu, H. Y., Chao, A. C., Chen, Y. Y., Yang, F. Y., Chung, C. P., Sheng, W. Y., ... Hu, H. H. (2008). Reflux of jugular and retrobulbar venous flow in transient monocular blindness. Annals of Neurology, 63(2), 247-253. https://doi.org/10.1002/ana.21299

Reflux of jugular and retrobulbar venous flow in transient monocular blindness. / Hsu, Hung Yi; Chao, A. Ching; Chen, Yen Yu; Yang, Fu Yi; Chung, Chih Ping; Sheng, Wen Yung; Yen, May Yung; Hu, Han Hwa.

In: Annals of Neurology, Vol. 63, No. 2, 01.02.2008, p. 247-253.

Research output: Contribution to journalArticle

Hsu, HY, Chao, AC, Chen, YY, Yang, FY, Chung, CP, Sheng, WY, Yen, MY & Hu, HH 2008, 'Reflux of jugular and retrobulbar venous flow in transient monocular blindness', Annals of Neurology, vol. 63, no. 2, pp. 247-253. https://doi.org/10.1002/ana.21299
Hsu HY, Chao AC, Chen YY, Yang FY, Chung CP, Sheng WY et al. Reflux of jugular and retrobulbar venous flow in transient monocular blindness. Annals of Neurology. 2008 Feb 1;63(2):247-253. https://doi.org/10.1002/ana.21299
Hsu, Hung Yi ; Chao, A. Ching ; Chen, Yen Yu ; Yang, Fu Yi ; Chung, Chih Ping ; Sheng, Wen Yung ; Yen, May Yung ; Hu, Han Hwa. / Reflux of jugular and retrobulbar venous flow in transient monocular blindness. In: Annals of Neurology. 2008 ; Vol. 63, No. 2. pp. 247-253.
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abstract = "Objective: Transient monocular blindness (TMB) attacks may occur during straining activities that impede cerebral venous return. Disturbance of cerebral and orbital venous circulation may be involved in TMB. Methods: Duplex ultrasonography and Doppler-flow measurement of jugular and retrobulbar veins were performed in 134 consecutive patients with TMB and 134 age- and sex-matched control subjects. All recruited patients received thorough examinations to screen for possible underlying causes. Results: Of the 134 patients with TMB, 48 patients had ipsilateral carotid arterial lesion and 7 patients had TMB attack(s) caused by cardiac embolism. Of the remaining 79 patients with undetermined cause, 46 had 3 or more TMB attacks (undetermined-frequent group) and 33 had fewer than 3 attacks. In comparison with the control subjects, the TMB patients had greater frequencies of jugular venous reflux (57 vs 30{\%}; p < 0.0001; odds ratio [OR]: 3.079, 95{\%} confidence intervals [CI]: 1.861-5.096) and flow reversal in the superior ophthalmic vein (RSOV; 37 vs 9{\%}; p < 0.0001; OR: 6.052, CI: 3.040-12.048). The undetermined-frequent group had the greatest frequencies of jugular venous reflux (74{\%}, 34 patients; OR: 6.66, CI: 3.13-14.17) and RSOV (59{\%}, 27 patients; OR: 6.51, CI: 3.12-13.58). Of the 50 patients with RSOV, 47 (94{\%}) had RSOV on the side of the TMB attacks. Interpretation: The increased incidences of jugular and orbital venous reflux in TMB patients suggest that disturbance of cerebral and orbital venous circulation is involved in the pathogenesis of TMB, especially among patients with frequent attacks of undetermined cause.",
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AU - Chao, A. Ching

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AU - Yang, Fu Yi

AU - Chung, Chih Ping

AU - Sheng, Wen Yung

AU - Yen, May Yung

AU - Hu, Han Hwa

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N2 - Objective: Transient monocular blindness (TMB) attacks may occur during straining activities that impede cerebral venous return. Disturbance of cerebral and orbital venous circulation may be involved in TMB. Methods: Duplex ultrasonography and Doppler-flow measurement of jugular and retrobulbar veins were performed in 134 consecutive patients with TMB and 134 age- and sex-matched control subjects. All recruited patients received thorough examinations to screen for possible underlying causes. Results: Of the 134 patients with TMB, 48 patients had ipsilateral carotid arterial lesion and 7 patients had TMB attack(s) caused by cardiac embolism. Of the remaining 79 patients with undetermined cause, 46 had 3 or more TMB attacks (undetermined-frequent group) and 33 had fewer than 3 attacks. In comparison with the control subjects, the TMB patients had greater frequencies of jugular venous reflux (57 vs 30%; p < 0.0001; odds ratio [OR]: 3.079, 95% confidence intervals [CI]: 1.861-5.096) and flow reversal in the superior ophthalmic vein (RSOV; 37 vs 9%; p < 0.0001; OR: 6.052, CI: 3.040-12.048). The undetermined-frequent group had the greatest frequencies of jugular venous reflux (74%, 34 patients; OR: 6.66, CI: 3.13-14.17) and RSOV (59%, 27 patients; OR: 6.51, CI: 3.12-13.58). Of the 50 patients with RSOV, 47 (94%) had RSOV on the side of the TMB attacks. Interpretation: The increased incidences of jugular and orbital venous reflux in TMB patients suggest that disturbance of cerebral and orbital venous circulation is involved in the pathogenesis of TMB, especially among patients with frequent attacks of undetermined cause.

AB - Objective: Transient monocular blindness (TMB) attacks may occur during straining activities that impede cerebral venous return. Disturbance of cerebral and orbital venous circulation may be involved in TMB. Methods: Duplex ultrasonography and Doppler-flow measurement of jugular and retrobulbar veins were performed in 134 consecutive patients with TMB and 134 age- and sex-matched control subjects. All recruited patients received thorough examinations to screen for possible underlying causes. Results: Of the 134 patients with TMB, 48 patients had ipsilateral carotid arterial lesion and 7 patients had TMB attack(s) caused by cardiac embolism. Of the remaining 79 patients with undetermined cause, 46 had 3 or more TMB attacks (undetermined-frequent group) and 33 had fewer than 3 attacks. In comparison with the control subjects, the TMB patients had greater frequencies of jugular venous reflux (57 vs 30%; p < 0.0001; odds ratio [OR]: 3.079, 95% confidence intervals [CI]: 1.861-5.096) and flow reversal in the superior ophthalmic vein (RSOV; 37 vs 9%; p < 0.0001; OR: 6.052, CI: 3.040-12.048). The undetermined-frequent group had the greatest frequencies of jugular venous reflux (74%, 34 patients; OR: 6.66, CI: 3.13-14.17) and RSOV (59%, 27 patients; OR: 6.51, CI: 3.12-13.58). Of the 50 patients with RSOV, 47 (94%) had RSOV on the side of the TMB attacks. Interpretation: The increased incidences of jugular and orbital venous reflux in TMB patients suggest that disturbance of cerebral and orbital venous circulation is involved in the pathogenesis of TMB, especially among patients with frequent attacks of undetermined cause.

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