Preserved vision despite distinct retinal edema in central retinal artery occlusion.

BACKGROUND

In subtotal central retinal artery occlusion (CRAO), distinct retinal edema with acute onset irreversible visual loss is common. -

METHODS

Clinical observation, fluorescein angiogram. -

PATIENT: A 69-year-old patient presented with acute visual loss of his right eye. Risk factors for CRAO were arterial hypertension and diabetes mellitus. A further factor was a 60% stenosis of the right and a 90% stenosis of the left internal carotid arteries. -

RESULT: Visual acuity at initial examination was 20/32 despite pronounced central retinal edema with characteristic cherry red spot of the macula. Fluorescein angiography demonstrated early filling of retinal vessels, only perfusion of the inferior macular vessels was delayed. Two months later retinal edema resolved and central visual acuity was 20/25. -

CONCLUSION

In this patient, retinal edema most likely resulted from a transient retinal ischemia. Spontaneous reperfusion occurred early enough to allow functional recovery in the ischemic retina.