Título

CYSTOIDMACULAR EDEMA IN ACUTE PRESENTATION OF CENTRAL RETINAL ARTERY OCCLUSION WITH THE PRESENCE OF CILIORETINAL ARTERY.

Introdução / Purpose

Central Retinal Artery Occlusion (CRAO) is an ocular emergency that leads to sudden monocular visual loss and carries a very poor prognosis¹.The incidence is estimated to be 1 in 100.000 people2 with less than 2% presenting with bilateral involvement. Risk factors are similar to other thromboembolic diseases and include hypertension, smoking, hyperlipidemia, diabetes, hypercoagulable states, and male gender.
One important variation to this is the presence of a cilioretinal artery and, in these patients, the macula may still be perfused in acute CRAO and its is possible for good vision to be maintained. Because of the variability in size of the cilioretinal artery and the area it supplies, that does not always happens 3.
In this case report we will present an atypical case of CRAO with patency of cilioretinal artey.

Material e Método / Methods

No apply

Resultados / Results

No apply

Discussão e Conclusões / Discussion

CRAO presents a classical sign known as cherry red spot foveal. It results of a generalized constriction of peripheral fields (32,3%) with almost always normal visual acuity. In this case, was found a visual field similar to the described before. However, the patient had a poorer visual acuity (20/150) at the presentation of symptoms. 3 This might be due to papillomacular bundle edema resulted by proinflammatory factors from ischemic event.5
Once CRA is responsible for inner retina vascularization, the signs of cellular suffering and its posterior damage is presented as a classic intracellular and intrarretinal edema in this layer. 7 OCT evaluation in CRAO usually shows an initial hyperreflectivity and increase of thickness of inner retina. 6 However, the case reported presents with the classic intracellular edema but also with extracellular cystoid edema, emphasizing it is not an usual presentation in CRAO. Joining all the information quoted above, we could suggest that in this case, CRAO did not only affect the inner layers, but also outer layer and outer blood-retinal barrier as well it was opted for intravitreal bevacizumab.

Palavras Chave

CYSTOIDMACULAR EDEMA ACUTE CENTRAL RETINAL ARTERY OCCLUSION CILIARY ARTERY