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Abstract
Case summary
A 26-year-old man complained of severe loss of vision in his left eye after falling and bumping his forehead on a staircase. His visual acuity was light perception in the left eye. Fundus examination revealed edematous white retina and a cherry red spot on the macula. Angiography showed severe stenosis in the initial segment of the ophthalmic artery with ophthalmic arterial embolus. He underwent intra-arterial thrombolysis with a clinical diagnosis of CRAO with ophthalmic artery stenosis. A 57-year-old woman presented with vision loss after falling and striking her face below her right lower eyelid on a wooden stick. Her visual acuity was hand motions in the right eye. Fundus examinations showed white retina with opacity and a cherry red spot on the macula. Fluorescein angiography and optical coherence tomography was performed, and a clinical diagnosis of CRAO was made.
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Figure 1.
Patient case 1. (A) Fundus photography before intra-arterial thrombolysis in case 1. There was edematous retina with typical cherry-red spot and fragmentation of retinal vessels compatible with central retinal artery occlusion. (B) Computed tomographic images showing left frontal sinus posterior wall fracture (arrow). (C) Arterial phase of left carotid angiogram (arrow). (D) There was severe stenosis of ophthalmic artery (arrow). (E) One day after intra-arterial thrombolysis. (F) Retinal arterial and venous filling was normalized except in the central macular region.
Figure 2.
Patient case 2. Fundus photography (A) and fluorescein angiography (B) in case 2. Retinal arterial filling was markedly delayed with arterio-venous transit time of 50 secs. (C) Computed tomographic images showing right multifocal retrobulbar hemorrhage (arrow). Fundus photography (D) and optical coherence tomography (E) 15 months after trauma. Disc pallor and inner retinal atrophy was observed.
Table 1.
Clinical characteristics of patients with CRAO after trauma
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