Amaurosis: definition, causes, symptoms, diagnosis and treatment

How can amaurosis affect vision? Are they all of congenital origin? What clinical examination can diagnose patients?… All the answers from Doctor Cati Albou-Ganem, ophthalmologist surgeon.

Amaurose: What is it?

“Amaurosis or temporary monocular blindness, is a pathology of sight resulting in complete or incomplete loss of vision., reports Doctor Cati Albou-Ganem, Ophthalmologist Surgeon and President and Founder of SoFem (Women’s Ophthalmological Society). This disease most often appears suddenly (sudden loss of vision), without disturbance of the eye areas.

What are the different types of amaurosis?

Amaurosis is a disorder that can be transient (ischemic accident known as AIT) or permanent visionand take the form uni or bilateral. There are different types:

• L’amaurose fugace comes from Greek “Amaurosis” which means “to darken”. It translates into a loss of monocular visual acuity (which only affects one eye) transient, without apparent lesion of the eye in herself. This blindness can be of vascular or nervous origin;

The causes of amaurosis

“Amaurosis is linked to neurosensory impairment of the retina or visual pathways”, explains Doctor Cati Albou-Ganem. That is to say, it is caused by damage to the eye itself or to the nerve optical (optic neuritis) due to a lack of blood flow to the eyes. Blood flow is then blocked to theretinal artery plant that supplies blood to the eyes which generates this amaurose fugace. This damage may be of vascular origin (cerebrovascular accident or CVA), tumoral, inflammatory, linked to a metabolic disorder (hyper or hypoglycaemia) or even to retinal detachment, migraine or a history of multiple sclerosis (autoimmune disease affecting the central nervous system). In case of amaurosis, “we must also think of Horton’s disease“, emphasizes Dr. Albou-Ganem.

Amaurosis: what are the symptoms?

Among the clinical symptoms of amaurosis are, among the main disorders, “a loss of total or partial visual acuity of the visual field of one or both eyes patients”, notes Cati Albou-Ganem. To these vision disorders can be added headaches, nausea/vomiting and intolerance to light.

How is the diagnosis made?

If amaurosis or any other transient visual disturbance is suspected, “and complete ophthalmological check-up with measurement of visual acuity, examination of all the structures of the eye (MRI), taking of the ocular pressure and fundus allows to make the diagnosis”reveals the specialist.

This clinical examination will be completed by a visual field, a biological, cardiovascular (looking for a possible stroke) and Neuro-ophthalmological assessment depending on the associated symptoms. An ultrasound of the neck vessels (Echo Doppler Vascular) may also be performed to look for a possible cholesterol plaque, an anomaly of the vessels or blood circulation.

What are the treatments to cure amaurosis?

“The treatment will vary depending on the origin of the amaurosis”, specifies the dr. Albou-Ganem. The treatment of fugitive amaurosis, for example, is based in particular on the management of cardiovascular risk. Hypertension, tobacco consumption and obesity being risk factors in amaurosis, treatment for high blood pressure, a healthy and balanced diet and smoking cessation are highly recommended.

Concerning I’amaurose congenital from Leber, there is currently no treatment to cure it. One hope, however, rests on the genetical therapy whose studies are encouraging and on theoptogenetics.

Possible complications of amaurosis

“It depends on the cause of the amaurosis”, says Dr. Albou-Ganem. Nevertheless, any transient amaurosis or visual disturbance is a transient ischemic attack until proven otherwise. The risk is therefore to suffer a serious constituted ischemic attack (form of cerebral vascular accident known as AVC), leaving heavy sequelae in the hours or days which follow. A history of amaurosis can also sometimes give rise to central retinal artery occlusion (OACR). This is a thrombosis of the main retinal artery.