PMC3990464_01
(A and B) Fundus photographs show superior temporal branch retinal artery occlusion in the OD and central retinal artery occlusion with cilioretinal artery sparing in the OS. (A) Morphological appearance suggests a Hollenhorst plaque at the first bifurcation of the temporal superior arterial vessel (black arrow). (B) A cherry-red spot can be seen against the pale retina. Attenuation and "boxcarring" of the blood column in the involved region were observed in OU. After the second bifurcation of the superior temporal retinal vessel, a small embolus (or fragment of the first one) is observed (a').. Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye); OU, oculi uterque (both eyes).
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Fundoscopy disclosed superior BRAO in the OD, with a Hollenhorst plaque at the first bifurcation of the superior temporal arterial branch, attenuation, and "boxcarring" of the blood column in the involved region (Figure 1A). Fundus examination disclosed CRAO with cilioretinal artery sparing in the OS (Figure 1B). Fundoscopy of the OD showed previous BRAO with a small embolus after the second bifurcation of the superior temporal retinal vessel (Figure 1a').
Spectral domain optical coherence tomography of the macula in the OS reveals a hyperreflective image corresponding to intracellular edema of the internal layers of the retina (366+-38 mum of foveal thickness), more prominent in the nasal quadrants.. Abbreviations: OS, oculus sinister (left eye); ILM, internal limiting membrane; RPE, retinal pigment epithelium.
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Spectral domain optical coherence tomography of the macula (Figure 2) showed a hyperreflective image in the OS, suggesting swelling of internal layers of the retina, and revealed 366+-38 mum of foveal thickness (more prominent in the nasal quadrants).
Fluorescein angiography (A and B) shows slowed filling of the superior temporal arterial branch in the OD and branches of the central retinal artery in the OS. The optic disk became pale in OU (a' and b') 3 months after bilateral retinal artery occlusion. The OD presented a pale aspect of the optic disk in the upper and temporal quadrants (a'), and the OS showed diffuse atrophy (b').. Abbreviations: OD, oculus dexter (right eye); OS, oculus sinister (left eye); OU, oculi uterque (both eyes).
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Fluorescein angiography showed impaired filling of the superior temporal arterial branch and branches of the central retinal artery (CRA) in the right and left eyes, respectively (Figure 3). Three months after BRAO, visual function remained stable, and both optic disks appeared pale (Figure 3a' and b').