Bilateral, multiple branch retinal artery occlusions (BRAOs) in NPSR. A, Fundus photographs show multiple acute BRAOs (arrows) in a 5 ½-year-old boy with Hb SS during a massive sickling episode. B, Fluorescein angiography images show numerous medium and large arteriolar vessel occlusions. C, The patient was treated promptly with a hypertransfusion protocol, which resulted in dramatic reperfusion of the retina. However, the corrected distance visual acuity did not improve beyond 20/200 in either eye.