Retinal vessel wall imaging using fluorescein angiography and adaptive optics imaging in acute branch retinal artery occlusion

Purpose To report the retinal vessel wall changes in a patient with acute branch retinal artery occlusion with fundus fluorescein angiography and adaptive optics imaging. Methods Retrospective, observational case Case description A 49-year-old female with cardiac ailment complained of sudden onset superior field loss for 4 days in her right eye. Her presenting visual acuity in the right eye was 20/20, N6. She was diagnosed with right eye infero-temporal branch retinal artery occlusion. A golden-yellow, round coloured embolus was noted on clinical examination obstructing the temporal division of the inferior branch of central retinal artery. Patient underwent ocular massage, anterior chamber paracentesis and oral Acetazolamide (Tab. Diamox 250 mg QID) medications. Vessel wall changes were noted using fluorescein angiography and adaptive optics retinal imaging at presentation and 10-day follow-up visit. Conclusion This case highlights the importance of multimodal retinal imaging like fluorescein angiography and adaptive optics imaging in identifying and understanding the retinal vessel wall changes in the occluded vascular segment of the retina.