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Last Month’s Blink

Central Retinal Artery Occlusion in Quiescent Diabetic Retinopathy

Written by Ana Ferreira, MD, and Rita Couceiro, MD. Photo by Bruno Pereira, COT. All are at Hospital Vila Franca de Xira, Lisbon, Portugal.

A 40-year-old man with a 15-year history of poorly controlled diabetes, hyper­tension, and dyslipidemia underwent bilateral vitrectomy and panretinal photocoagulation in 2015 for vitreous hemorrhages and proliferative diabetic retinopathy (PDR) in both eyes. He also had a cilioretinal artery occlusion in the left eye in 2016, which resulted in hand motions vision in that eye.

The patient was now complaining of acute and painless vision loss in the right eye for the past 15 days. Visual acuity had dropped from 20/40 to 20/100. Funduscopy of the right eye revealed nonperfusion of several retinal arterioles emerg­ing from the optic disc (Fig. 1). Other features included quiescent PDR, optic disc pallor, and papillary involuted fibrotic neovessels. Arterial nonperfusion was also evident on optical coher­ence tomography angiography (Fig. 2), suggesting central retinal artery occlusion in the right eye.

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