PMC7452947_01
a) Color fundus photograph showing a fibrin-platelet embolus (arrow) and opacification of the retina along the superior-temporal vascular arcade;. b) Fluorescein angiogram of the same patient demonstrating a blood flow defect in the affected superior temporal artery
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F1
Dilated fundus examination revealed a superior temporal artery branch occlusion with retinal paleness in the upper region of the macula, with a visible transluminal platelet-fibrin embolus at the arterial bifurcation, and numerous other small fibrin emboli scattered along the arterial branch (Figure 1a (Fig. 1)). FA showed delayed filling of the superotemporal artery and hypofluorescence in the surrounding artery (Figure 1b (Fig. 1)). HD-OCT revealed diffuse thickening of the inner retinal layers and increased reflectivity (Figure 2a (Fig. 2)), accompanied by a superior arcuate visual field defect in the VF testing (Figure 3a (Fig. 3)). Following initial ocular massage and application of anti-glaucomatous eye drops, cardiology consultation and carotid Doppler ultrasound were requested.
a) Optical coherence tomogram (OCT) demonstrating retinal edema in the superior temporal retinal artery region;. b) OCT image shows improvements of retinal thickening one month following the combined treatment
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F2
FA showed delayed filling of the superotemporal artery and hypofluorescence in the surrounding artery (Figure 1b (Fig. 1)). HD-OCT revealed diffuse thickening of the inner retinal layers and increased reflectivity (Figure 2a (Fig. 2)), accompanied by a superior arcuate visual field defect in the VF testing (Figure 3a (Fig. 3)). Following initial ocular massage and application of anti-glaucomatous eye drops, cardiology consultation and carotid Doppler ultrasound were requested. In the follow-up FA, the normal blood flow was seen in the affected artery (Figure 4b (Fig. 4)), and the edema was noted to be regressed in the OCT image (Figure 2b (Fig. 2)).
a) Visual field demonstrating inferior arcuate scotoma;. b) Visual field after the combined treatment showing partial recovery of inferior arcuate scotoma
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F3
FA showed delayed filling of the superotemporal artery and hypofluorescence in the surrounding artery (Figure 1b (Fig. 1)). HD-OCT revealed diffuse thickening of the inner retinal layers and increased reflectivity (Figure 2a (Fig. 2)), accompanied by a superior arcuate visual field defect in the VF testing (Figure 3a (Fig. 3)). Following initial ocular massage and application of anti-glaucomatous eye drops, cardiology consultation and carotid Doppler ultrasound were requested. Humphrey 30-2 VF testing showed inferior arcuate scotoma (Figure 3a (Fig. 3)). In the last examination done after 12 months, the patient's visual acuity was 0.9, with inferior nasal quadrant scotoma (Figure 3b (Fig. 3)), no macular edema on OCT, normal appearance of the fundus and no visible edema.
a) Color fundus photograph one week following TYE and HBO combined treatment;. b) Fluorescein angiogram showing recovery of retinal blood flow
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F4
In the fundus examination, no embolic material and hemorrhage was seen, and paleness in the upper temporal field of the macula had decreased (Figure 4a (Fig. 4)). In the follow-up FA, the normal blood flow was seen in the affected artery (Figure 4b (Fig. 4)), and the edema was noted to be regressed in the OCT image (Figure 2b (Fig. 2)).