A Case of Incomplete Central Retinal Artery Occlusion Associated with Short Posterior Ciliary Artery Occlusion

Shinji Makino,Yukihiro Sato,Mikiko Takezawa

doi:10.1155/2013/105653

Shinji Makino, Yukihiro Sato + Show 1 more

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https://doi.org/10.1155/2013/105653

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Abstract

To our knowledge, incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion is extremely rare. Herein, we describe a case of a 62-year-old man who was referred to our hospital with of transient blindness in his right eye. At initial examination, the patient's best-corrected visual acuity was 18/20 in the right eye. Fundus examination showed multiple soft exudates around the optic disc and mild macular retinal edema in his right eye; however, a cherry red spot on the macula was not detected. Fluorescein angiography revealed delayed dye inflow into the nasal choroidal hemisphere that is supplied by the short posterior ciliary artery. The following day, the patient's visual acuity improved to 20/20. Soft exudates around the optic disc increased during observation and gradually disappeared. His hemodynamic parameters revealed subclavian steal syndrome as examined by cervical ultrasonography and digital subtraction angiography. We speculate that his transient blindness was due to ophthalmic artery spasms. In this particular case, spasms of the ophthalmic artery and occlusion of the short posterior ciliary artery occurred simultaneously. As the short posterior ciliary artery branches from the ophthalmic artery, the anatomical location of the lesion might be near the branching of both arteries.

Highlights

Ere are only few reports in the Japanese literature that have presented the incomplete type of central retinal artery occlusion (CRAO), including diminished visual acuity and a residual visual eld but no complete visual loss, slight retinal edema together with a slight cherry red spot on the macula, and good visual prognosis [1, 2]
Incomplete CRAO associated with short posterior ciliary artery occlusion is extremely rare [1]
In 2002, Schmidt et al [12] classi ed CRAO into 3 stages; stage I of his classi cation represents incomplete CRAO and includes diminished visual acuity and a residual visual eld but no complete visual loss, slight retinal edema together with a slight cherry red spot on the macula, no increase in retinal signs over several hours, and delayed but not completely interrupted blood ow revealed by Fluorescein angiography (FA). ey reported that spontaneous recovery usually did not occur during a followup of several hours despite minor retinal ndings. e fundus changes in stage I described in their literature [12] were very similar to those in our case

Summary

Case Report

A Case of Incomplete Central Retinal Artery Occlusion Associated with Short Posterior Ciliary Artery Occlusion. Incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion is extremely rare. The patient’s best-corrected visual acuity was 18/20 in the right eye. Fundus examination showed multiple so exudates around the optic disc and mild macular retinal edema in his right eye; a cherry red spot on the macula was not detected. Exudates around the optic disc increased during observation and gradually disappeared His hemodynamic parameters revealed subclavian steal syndrome as examined by cervical ultrasonography and digital subtraction angiography. We speculate that his transient blindness was due to ophthalmic artery spasms. As the short posterior ciliary artery branches from the ophthalmic artery, the anatomical location of the lesion might be near the branching of both arteries

Introduction

Discussion