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Incidental branch retinal artery occlusion on optical coherence tomography angiography presenting as segmental optic atrophy in a child: a case report.

Abstract Retinal artery occlusion is extremely rare in the pediatric population and most patients have risk factors. We report a case of a healthy child with segmental optic atrophy, complicated by incidental branch retinal artery occlusion (BRAO).
PMID
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Authors

Mayor MeshTerms
Keywords

Branch retinal artery occlusion

Childhood optic atrophy

Segmental optic atrophy

Spectral domain optical coherence tomography

Spectral domain optical coherence tomography angiography

Journal Title bmc ophthalmology
Publication Year Start




PMID- 29258533
OWN - NLM
STAT- MEDLINE
DCOM- 20180105
LR  - 20180105
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Dec 19
TI  - Incidental branch retinal artery occlusion on optical coherence tomography
      angiography presenting as segmental optic atrophy in a child: a case report.
PG  - 256
LID - 10.1186/s12886-017-0653-6 [doi]
AB  - BACKGROUND: Retinal artery occlusion is extremely rare in the pediatric
      population and most patients have risk factors. We report a case of a healthy
      child with segmental optic atrophy, complicated by incidental branch retinal
      artery occlusion (BRAO). CASE PRESENTATION: A 10-year-old boy who had a history
      of his mother's gestational diabetes presented with an inferonasal visual field
      defect in the left eye. His best-corrected visual acuities were 20/20 in both
      eyes (OU). Fundoscopic examination revealed segmental pallor of the left optic
      disc, thinning of the superotemporal rim, a relative superior entrance of the
      central retinal artery and superior peripapillary scleral halo. Fluorescein
      angiography showed patchy filling delays in the corresponding disc area without
      retinal vascular abnormalities. Spectral domain optical coherence tomography (SD 
      OCT) via automated segmentation analysis demonstrated sectoral absence of the
      ganglion cell layer and retinal nerve fiber layer with thinning of the inner
      plexiform layer, inner nuclear layer and outer plexiform layer in the
      corresponding retina. OCT angiography (OCTA) showed focal attenuation of
      superficial and intermediate/deep capillary plexuses in the corresponding areas. 
      Systemic evaluation was unremarkable. The patient was diagnosed with segmental
      optic atrophy caused by incidental BRAO. CONCLUSIONS: Retinal vascular occlusions
      are rare in childhood, and may present as segmental optic atrophy mimicking
      congenital anomalies. OCTA allows the detection of previous microvascular
      abnormalities in the chronic phase. To the best of our knowledge, this is the
      first report of a child with segmental optic atrophy presumably caused by BRAO,
      which was documented by SD OCT and OCTA in detail.
FAU - Choi, Ji Hyung
AU  - Choi JH
AD  - Department of Ophthalmology, Maryknoll Medical Center, 121, Junggu-ro, Jung-gu,
      Busan, 48972, South Korea.
FAU - Yang, Hee Kyung
AU  - Yang HK
AD  - Department of Ophthalmology, Seoul National University College of Medicine, Seoul
      National University Bundang Hospital, #166, Gumiro, Bundang-gu, Seongnam,
      Gyeonggi-do, 463-707, South Korea.
FAU - Lee, Ji Eun
AU  - Lee JE
AUID- ORCID: http://orcid.org/0000-0002-8938-0227
AD  - Department of Ophthalmology, Maryknoll Medical Center, 121, Junggu-ro, Jung-gu,
      Busan, 48972, South Korea. [email protected]
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20171219
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
SB  - IM
MH  - Child
MH  - Diagnosis, Differential
MH  - Humans
MH  - Male
MH  - Optic Atrophy/*diagnostic imaging
MH  - Retinal Artery Occlusion/*diagnostic imaging
MH  - Tomography, Optical Coherence/*methods
PMC - PMC5738177
OTO - NOTNLM
OT  - Branch retinal artery occlusion
OT  - Childhood optic atrophy
OT  - Segmental optic atrophy
OT  - Spectral domain optical coherence tomography
OT  - Spectral domain optical coherence tomography angiography
EDAT- 2017/12/21 06:00
MHDA- 2018/01/06 06:00
CRDT- 2017/12/21 06:00
PHST- 2017/08/31 00:00 [received]
PHST- 2017/12/10 00:00 [accepted]
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2018/01/06 06:00 [medline]
AID - 10.1186/s12886-017-0653-6 [doi]
AID - 10.1186/s12886-017-0653-6 [pii]
PST - epublish
SO  - BMC Ophthalmol. 2017 Dec 19;17(1):256. doi: 10.1186/s12886-017-0653-6.