Pearls & Oy-sters: Trace Visualization of the Central Retinal Artery: A Favorable Sign for Late-Window Endovascular Therapy in Central Retinal Artery Occlusion.
Yang Du, Zhongqi Qi, Lu Cong et al.
✦ AI-curated · Sources linked
Case in brief
A 69-year-old man presented with 18 hours of acute, severe blurred vision in the right eye. Fundus examination and optical coherence tomography showed central retinal artery occlusion with inner retinal edema. Digital subtraction angiography demonstrated severe stenosis of the right internal carotid artery at C1, delayed ophthalmic artery filling, and faint visualization of the central retinal artery. Following multidisciplinary consultation, he underwent internal carotid artery stenting. Imaging showed resolution of the stenosis and improved retinal perfusion, and his vision improved and then stabilized.
What made this case unusual
Despite presentation beyond the traditional treatment window, angiography faintly visualized the central retinal artery, suggesting residual flow; visual improvement followed carotid revascularization.
Diagnostic / clinical pearl
In central retinal artery occlusion, faint angiographic visualization of the artery may indicate residual flow and provide a rationale to consider recanalization therapy, even with late presentation.