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A rare case having hemi-retinal artery occlusion in one eye and hemi-retinal vein occlusion in the other: Diverse manifestations of retinal vascular occlusion

A 58‐year‐old woman presented with sudden blurring of vision in OD for 15 days and in OS since 2 months. She was a known hypertensive and diabetic for past 10 years on insulin, on irregular treatment. Blood pressure (BP) noted was 160/100 mmHg, with HbA1c of 10.6 gm/dl. Best‐corrected visual acuity (BCVA) was 20/200 in OD and 20/600 in OS. Anterior segment was unremarkable in OU. Fundus OD [Fig. 1a] showed inferior hemi‐retinal vein occlusion (HRVO). OS fundus [Fig. 1b] revealed inferior hemi‐retinal arterial occlusion (HRAO) with Hollenhorst plaque in infero‐temporal artery (arrow, Fig. 1b). Fundus fluorescein angiography (FFA) showed blocked fluorescence with perivascular leak and macular edema in OD [Fig. 1c] and large areas of capillary non‐perfusion in inferior retina and neovascularization of the disc (NVD) in OS [Fig. 1d]. Swept‐source optical coherence tomography (SS‐OCT) showed intraretinal and subretinal fluid in OD [Fig. 1e] and retinal atrophy in the inferior hemi‐retina in OS with superior retina being normal [Fig. 1f]. Patient was diagnosed to have inferior HRVO with macular edema in OD and old inferior HRAO with NVD in OS.