A rare case demonstrates visual loss from branch retinal artery occlusion in an individual with hypertension and diabetes, suggesting distinct prognosis implications.
A 48-year-old man with hypertension and diabetes presented with sudden, painless vision loss in the left eye (OS) for 8 days, with superior and nasal field defects. He also had transient right-sided weakness and numbness lasting 1 hour. Visual acuity was 6/6 in the right eye (OD) and 1/60 in OS. Fundus examination revealed OD grade 2 hypertensive retinopathy and OS inferotemporal branch retinal artery occlusion (BRAO) with a cherry-red spot, sparing the papillomacular bundle. Blood pressure was 160/110 mmHg, with elevated homocysteine and dyslipidemia. MRI brain and orbit showed a subacute lacunar infarct. Systemic management improved vision from 1/60 to 3/60. This represents a rare case of BRAO with a cherry-red spot, showing a prognosis worse than typical BRAO but better than CRAO due to cilioretinal artery sparing.
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Iyer et al. (2026) studied this question.
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