Abstract
Purpose: :
To describe the acute anatomic changes of the macula in a case of branch retinal artery occlusion (BRAO) as documented by optical coherence tomography (OCT).
Methods: :
A seventy one year old man presented within two hours of the sudden onset of painless unilateral vision loss in the left eye. He described a "car shaped" scotoma immediately superior to fixation. Complete ophthalmic exam was performed. Prompt imaging was undertaken, including OCT, fundus photographs, and fluorescein angiography. The patient was followed with serial clinical exams and repeat imaging.
Results: :
The initial exam revealed visual acuity of 20/200 and a superior scotoma extending from fixation. Fundus exam revealed a Hollenhost plaque of the inferotemporal arteriole and an associated area of macular infarction. The angiogram showed an area of retinal hypoperfusion in the distrubution of the involved vessel. OCT demonstrated corresponding inferior macular edema. Subsequent OCT imaging showed resolution of the edema and progression to mild thinning.
Conclusions: :
Acute retinal edema develops as an early component of branch retinal artery occlusion. This finding is well demonstrated by OCT, as well as the subsequent edema resolution and development of atrophy over the following weeks. To our knowledge, these acute OCT findings in BRVO have not previously been descibed.
Keywords: vascular occlusion/vascular occlusive disease • retina • anatomy