A Case of Idiopathic Pediatric Acute Branch Retinal Artery Occlusion Involving the Macular Area

Ji Hye Jang; Jong Won Moon; Young Wook Cho

doi:10.3341/jkos.2014.55.2.304

Journal List > J Korean Ophthalmol Soc > v.55(2) > 1009895

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Jang, Moon, and Cho: A Case of Idiopathic Pediatric Acute Branch Retinal Artery Occlusion Involving the Macular Area

Original Article

J Korean Ophthalmol Soc 2014;55(2):304-308.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.2.304

A Case of Idiopathic Pediatric Acute Branch Retinal Artery Occlusion Involving the Macular Area

Ji Hye Jang, MD, Jong Won Moon, MD, Young Wook Cho, MD

Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea

Address reprint requests to Ji Hye Jang, MD Department of Ophthalmology, Daegu Fatima Hospital, #99 Ayang-ro, Dong-gu, Daegu 701-724, Korea, Tel: 82-53-940-7545, Fax: 82-53-954-7417, E-mail: mjmom99@naver.com

Received 26 April 20137 October 2013 Accepted 20 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report a case of branch retinal artery occlusion (BRAO) interconnected with the perifoveal capillaries in a healthy young female.

Case summary

A 16- year- old female presented with sudden loss of vision in her left eye. Upon initial examination, her left visual acuity was 0.02 and intraocular pressure was 31 mm Hg. Fundus examination revealed pallid retinal edema of the inferior posterior pole and retinal hemorrhage below optic disc. Ocular massage followed by anterior chamber para-centesis was performed for 30 minutes within 4 hours after the onset of vision loss. Fluorescein angiography (FAG) showed a very slow blood flow in the superotemporal and inferotemporal retinal arteries and a delay in retinal arteriovenous transit time. We performed hemodynamic tests such as blood pressure, echocardiography, and the hematologic test for thrombogenicity and all tests were normal. At three weeks after treatment, vision in the left eye was 0.7 and FAG revealed normal retinal arterial circulation and venous drainage time.

Conclusions

This is the first report regarding acute BRAO in a healthy Korean child without any detectable systemic disorder. Prompt treatment can prevent permanent visual loss in BRAO involving the macular area.

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Keywords: Acute branch retinal artery occlusion, Idiopathic pediatric, Macular area

References

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Figure 1.

Color fundus photography of the right eye shows a normal retina (A), a pale retina along the inferotemporal vascular arcade, mild venous tortuosity, and flame shaped retinal hemorrhages are seen in the left eye (B).

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Figure 2.

Fluorescent angiography of the left eye after ocular massage. Superotemporal and inferotemporal branch retinal arteries filling is very delayed, whereas the choroidal vascular bed fills normally. Ateriovenous transit time (E-B) is delayed to about 32 seconds. Dye is reached to temporal peripheral area for 2 minutes. Red arrows show the sites of the downstream filling defects.

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Figure 3.

Color fundus photography and fluorescent angiography of the left eye 3 weeks after treatment. Arterial filling and arteriovenous transit time is normal. There is no retinal arterial occlusion.

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Figure 4.

Visual field examination of the left eye (A) at initial examination, (B) at 3 weeks after treatment. Visual field reveals slight superior central scotoma within 10 degrees.

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