Central Retinal Artery Occlusion in a Patient with Aortic Valve Papillary Fibroelastoma: A Case Report

Figures

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  Figure 1. Findings of fundoscopy. Panel A shows the fundus of the patient’s right eye. There is retinal pallor (white arrowheads, indicating ischaemic inner retinal tissue), a cherry red spot (white thin arrow, reflecting preserved choroidal perfusion at the fovea), and a small area of normally perfused retina inferior to the optic disc due to a patent cilioretinal artery (white block arrow). Panel B shows the fundus of the contralateral, healthy (left) eye with a normally perfused retina and arteriolar narrowing (black arrow, a sign of chronic hypertensive vascular changes).

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  Figure 2. Findings of optical coherence tomography. Panel A shows thickening of the inner retinal layers (arrow) due to cytotoxic oedema. Panel B shows the healthy retina of the contralateral eye with normal retinal layers (arrow).

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  Figure 3. Transesophageal echocardiography demonstrating a small, mobile mass attached to the left coronary cusp of the aortic valve, consistent with papillary fibroelastoma. A corresponding video illustrating this finding is available in the Supplementary material.

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  Figure 4. Histopathological sections of the resected papillary fibroelastoma. (A) Haematoxylin–eosin staining shows the fibroelastic tissue with blue-stained nuclei and pink-stained cytoplasm and collagenous structures. (B) Elastika–van-Gieson staining highlights the fibroelastic architecture, with collagen fibres in pale red, elastic fibres in black-violet, nuclei in black-blue/brown, and cytoplasm in yellow. Both stainings demonstrate the characteristic morphology of a papillary fibroelastoma.