THE SOURCE OF EMBOLISM IN AMAUROSIS FUGAX AND RETINAL ARTERY-OCCLUSION

To assess the diagnostic value of an extensive cardiac screening and o f carotid artery duplex scanning in patients suspected of suffering fr om retinal embolism, we examined 41 consecutive patients (mean age 59. 6 years, range 36-74) who presented either with amaurosis fugax or wit h a retinal artery occlusion. In spite of extensive investigations, we found no cause in 27 patients (66%). In 11 patients (27%), symptoms w ere likely to be due to a stenosis or an occlusion of the ipsilateral carotid artery. In only 1 patient (2%), the heart was likely to be a s ource of embolism. We conclude that in patients in this age group suff ering from either amaurosis fugax or a retinal artery occlusion, a car otid artery duplex scanning should be performed first as this investig ation is more likely to provide useful information than an extensive c ardiac screening (ECG, Holter 24-hour monitoring and precordial echoca rdiography).