Título / Title

CILIORETINAL ARTERY OCCLUSION AND MULTIMODAL IMAGE

Introdução / Purpose

To report two isolated cases of cilioretinal artery occlusion and multimodal imaging.

Material e Método / Methods

Case 1: Male, 47 years old, complaint of sudden and painless central spot in the left eye. Deny comorbidities, use of medications or recent surgeries. Visual acuity: OD: 1.0 and OS: 0.5. Fundus of the OD was normal, but in the OS there was a pallor area superior to the papillomacular bundle.
Case 2: Male, 42 years old, complaint of sudden loss of vision in the right eye. He has mitral insufficiency and uses acetylsalicylic acid, hydrochlorothiazide and captopril. Visual acuity: OD: counting fingers and OS: 1,0. Fundus of the OD has a pallor area in the papillomacular bundle.
Fluorescein angiography, optical coherence tomography (OCT) and OCT angiography (OCTA) were requested to confirm clinical suspicion and cardiovascular assessment with carotid echocardiography. Red free photos were helpful to identify cilioretinal artery.

Resultados / Results

Results: At angiography, there were no areas of non-perfusion or emboli in the arterial circulation. OCT showed hyperreflectivity in the inner layers of the retina due to intracellular edema. After 2 months there was reduction of inner retinal thickness in OCT. OCTA evidenced areas of non-perfusion in the papillomacular bundle and diminished vascular density of the deep plexus.

Discussão e Conclusões / Conclusion

The authors performed a PubMed search and believe this to be the first published documentation of OCTA findings in cilioretinal artery occlusion. It is important to highlight that the intracellular edema could create a hyporeflective artifact, what might be tricky.
The visual prognosis of cilioretinal artery occlusion is significantly better than for other types of retinal artery occlusions, with the exception of cases associated with giant cell arteritis.

Palavras Chave

Cilioretinal Artery Occlusion, optical coherence tomography angiography ,