Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2020; 8(5): 980-985
Published online Mar 6, 2020. doi: 10.12998/wjcc.v8.i5.980
Anomalous retinal artery associated with branch retinal artery occlusion and neovascular glaucoma: A case report
Wan-Ju Yang, Yan-Ning Yang, Ming-Gao Cai, Yi-Qiao Xing
Wan-Ju Yang, Yan-Ning Yang, Ming-Gao Cai, Yi-Qiao Xing, Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Wan-Ju Yang, Department of Ophthalmology, The Central Hospital of Wuhan, Tongji Medical, College of Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
Author contributions: Yang WJ, Yang YN, Cai MG, and Xing YQ conceived and designed the research study; Yang WJ, Yang YN, and Cai MG collected data and conducted the research; Yang WJ, Yang YN, and Cai MG analyzed and interpreted the data; Yang WJ and Yang YN wrote the initial draft of the manuscript; Yang YN and Xing YQ revised the paper; Yang YN has primary responsibility for the content of the final version of the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yan-Ning Yang, MD, Chief Doctor, Eye Center, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan 430060, Hubei Province, China. ophyyn@gmail.com
Received: November 26, 2019
Peer-review started: November 26, 2019
First decision: January 7, 2020
Revised: January 16, 2020
Accepted: January 24, 2020
Article in press: January 24, 2020
Published online: March 6, 2020
Abstract
BACKGROUND

Congenital anomalous retinal artery is rare and does not typically affect visual acuity. However, an abnormal artery that passes through and supplies blood to the macular area complicated with branch retinal artery occlusion may negatively impact visual acuity. This study reports an unusual case of anomalous retinal artery combined with retinal artery occlusion.

CASE SUMMARY

A 52-year-old male presented with severely reduced vision in the right eye. The fundus examination revealed an anomalous artery, extending from the superior temporal arcade and crossing the macula into the inferior temporal quadrant. The anomalous artery was partially occluded, with a narrowed lumen. A cherry-red spot was observed with whitening of the macular area, suggesting macular edema. Fundus fluorescein angiography revealed disc leakage and a delayed filling time. Optical coherence tomography revealed increased thickness of the neuroretina and underlying layers. The patient was treated with vessel dilation, hyperbaric oxygen, ocular massage, and thrombolytics. Visual acuity of the right eye subsequently improved to 20/200 from hand motion at 4 cm. This improvement in visual acuity persisted when the patient was examined at the 1-mo follow-up visit. The patient was subsequently followed via telephone interview. The information provided via interview indicated that visual acuity in the affected eye was stable up to 6 years from the time of the initial presentation. However, after 3 additional years, the patient was diagnosed with neovascular glaucoma in the right eye, which was subsequently enucleated.

CONCLUSION

Although congenital retinal vascular anomaly, including anomalous retinal artery, rarely affects vision, when complicated with branch retinal artery occlusion, the abnormal artery that supplies the macula may severely reduce visual acuity.

Keywords: Branch retinal artery occlusion, Vascular abnormality, Case report

Core tip: We report an extremely rare case of retinal vascular anomaly in combination with branch retinal artery occlusion (BRAO) that led to severe loss of vision in the affected eye. In this case, a large artery branch originated at the superior temporal arcade, and then crossed the horizontal raphe to travel through the macular area. The patient denied all known risk factors for BRAO. The eye with the anomalous retinal artery eventually developed neovascular glaucoma with complete loss of vision. We speculate that the neovascular glaucoma may have been associated with BRAO recurrence.