Sequential bilateral retinal artery occlusions with promising visual prognosis in a diabetic patient: a case report and literature review.

BACKGROUND

Bilateral retinal artery occlusion (RAO) in patients with Type 2 diabetes mellitus is an extremely rare condition. Even with rigorous treatment, RAO often results in devastating visual impairment.

CASE PRESENTATION: A 50-year-old female with Type 2 diabetes mellitus was referred to our hospital. Notably, she developed bilateral RAO sequentially within a mere five-month period. This rapid progression of the disease in both eyes is of particular interest.

OBSERVATIONS: Fundus examination confirmed branch retinal artery occlusion (BRAO) in her left eye and central retinal artery occlusion (CRAO) in her right eye. After timely intra-arterial thrombolysis, significant bilateral visual recovery was achieved. The patient's visual acuity in the left eye improved from 20/400 to 20/100 and in the right eye from 20/2000 to 20/33.3, indicating the effectiveness of this treatment approach in this case. Further examinations also showed positive results: the cherry-red spot in the macula disappeared, FFA indicated improved retinal artery perfusion, and OCT revealed a certain degree of restoration in the retinal structure.

CONCLUSION

This case highlights that metabolic disorders, like hyperlipidemia and diabetes, can be considered high-risk factors for the development of RAO. Prompt and effective intervention, such as timely intra-arterial thrombolysis, as demonstrated in this case, is crucial for preserving patients' visual prognosis.