PMC3861853_01
Color fundus photograph (a) and red free image (b) of both eyes at presentation. The left eye shows signs of neuroretinitis and an inner retinal infarct due to a superotemporal branch retinal artery occlusion.
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F1
A characteristic partial macular star sparing the area temporal to the fovea was also observed OS (fig. 1). A branch of the superior-temporal retinal artery was occluded, but the arteriole supplying the superior part of the macula remained patent (fig. 1, fig. 2). Venous tortuosity and peripapillary telangiectasia were present, but there was no sign of concomitant vein occlusion (fig. 1, fig. 2).
a Left eye fluorescein angiogram, venous phase, shows generalized vascular congestion, capillary nonperfusion in the superior vascular arcade territory (small arrows) and reduced superotemporal venous return (large arrow). Perfusion of the central macula is largely preserved. b, c Follow-up fluorescein angiogram of the left eye after 2 months. Early venous (b) and venous (c) phase. Despite reperfusion of the previously infarcted superior retina, superotemporal venous return is still significantly delayed.
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F2
After 2 months of doxycycline therapy, the disc and retinal edema had improved significantly and most retinal vessels returned to normal caliber (fig. 2).
Baseline Humphrey 30-2 visual fields at presentation (a) and 2 weeks later (b). Follow-up visual field at 2 months shows improvement of central defects and a diminished blind spot after the resorption of edema. Inferior arcuate scotoma persisted due to inner retinal infarct in the acute phase.
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F3
Central visual field defects improved with the resolution of macular edema, but the branch retinal artery occlusion resulted in inner retinal infarct with a persistent inferior arcuate scotoma (fig. 3).