Cilioretinal Artery Occlusion

Cilioretinal Artery Occlusion

Category(ies): Retina/Vitreous

Contributor: Austin Fox, MD and Stephen Russell, MD

Photographer: Susan Wright

A 67-year-old man with history of type 2 diabetes mellitus, hyperlipidemia, and uncontrolled hypertension presented with a central visual field deficit of sudden onset in his right eye. Visual acuity on presentation was 20/25 in both eyes, and funduscopic examination revealed an isolated cilioretinal artery occlusion (CLRAO) in his right eye (Figure 1). Work-up revealed significant right internal carotid artery stenosis (>50%). A right carotid endarterectomy was performed, and vascular risk factors were optimized. Visual acuity was stable at 20/25 one month after presentation.

CLRAO accounts for ~5-7% of retinal artery occlusions and is usually associated with a central retinal vein occlusion (CRVO) or anterior ischemic optic neuropathy (AION). [1-3] Less commonly, CLRAOs may occur as an isolated phenomenon as in this case. Isolated CLRAOs typically have a better visual prognosis than those associated with a CRVO or AION with 90% of patients achieving a visual acuity of 20/40 or better. [3]

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Reference:

• Brown GC, Shields JA. Cilioretinal arteries and retinal arterial occlusion. Arch Ophthalmol. 1979;97:84–92.
• Hayreh SS. Pathogenesis of occlusion of the central retinal vessels. Am J Ophthalmol 1971;72:998–1011
• Brown GC, Moffat K, Cruess A, Magargal LE, Goldberg RE. Cilioretinal artery obstruction. Retina. 1983;3(3):182-7

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