Re-evaluating Our Perspective on Retinal Artery Occlusion from Carotid Dissection: A Report of Three Cases and Review of the Literature

BACKGROUND AND OBJECTIVE: Retinal artery occlusion from carotid dissection is rare and classically considered a post-traumatic phenomenon occurring in young patients and associated with additional symptoms of dissection such as neck pain, headache, or focal neurological deficits. PATIENTS AND METHODS: The authors report three cases of retinal artery occlusion due to carotid artery dissection and briefly review the literature. RESULTS: Antecedent trauma or neck injury was reported in only 42% (five of 12) of previously reported cases and in none of the three cases presented here. All three patients in this series initially denied symptoms such as headache or neck pain; however, one patient's wife later recalled her husband experiencing minor neck soreness several days prior to visual loss. In 17% (two of 12) of previously reported cases, no additional symptoms of carotid dissection were reported. CONCLUSION: These cases highlight the importance of considering carotid dissection in young patients with retinal artery occlusion, even in the absence of a report of recent trauma or associated symptoms such as pain.