Abstract
A 66-year-old man was admitted to our hospital because of intermittent claudication, pretibial edema and blurred vision in his right eye. He was diagnosed as having diabetes mellitus accompanied by hypertension, arteriosclerosis obliterans and multiple brain infarctions.On admission, he had preproliferative retinopathy in his right optic fundus, whereas his left eye was unaffected. Brain CT revealed old multiple infarctions in the right basal ganglia and left occipito-temporal region.Cerebral angiography revealed occlusion of the left internal carotid artery, together with stenosis of the right internal carotid and right ophthalmic arteries.The left ophthalmic artery was filled by the left external carotid artery.In this case, retinopathy did not exist on the completely occluded side, but rather on the less severely sclerotic side of the internal carotid artery, probably due to unusual collateral circulation in the intracranial arteries and also in the external-internal vasculature.Since asymmetric retinopathy in diabetic patients probably reflects the existence of an extraocular local hemodynamic disturbance leading to stroke, carotid and intracranial arteries in such patients should be carefully examined.
