Anomalous retinal artery associated with branch retinal artery occlusion and neovascular glaucoma: A case report

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.