Fig. 2

Fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) features of case 5: A 41-year-old male with a systemic history of hypertension and hypercholesterolemia presented to the retina clinic with sudden vision loss in the right eye over the course of the last few hours. His right eye vision was hand motions. On the day of presentation, an OCT scan of the right eye revealed moderate severity of CRAO with inner retinal hyperreflectivity and thickening. On the following day, FFA was performed, revealing the absence of a patent temporal cilioretinal artery and an arm-retina time of 26.3 s. Multiple hyperfluorescent pinpoint spots were identified in the FFA’s middle phase. They were associated with minimal vascular leakage and staining in the final phase of the FFA (A-C). Nine days later, OCT and FFA imaging of the retina was repeated. The OCT scan revealed inner retinal hyperreflectivity, thickening and loss of retinal layer stratification suggestive of a severe grade of occlusion in the central retinal artery. This was associated with the development of cystoid macular edema, neurosensory detachment and internal limiting membrane separation as well. Similar to the previous FFA visit, the FFA at this visit showed similar findings of middle phase pinpoint hyperfluorescent spots with late staining and vascular leakage (D-F). Thirty days from the initial presentation, retinal imaging with OCT and FFA were repeated. OCT showed thinning of the inner retinal layers, resolution of the cystoid macular edema, neurosensory detachment and internal limiting membrane separation. During this imaging session, the hyperfluorescent pinpoint spots observed in the previous FFA images had disappeared (G-I).