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[The change of retinal arteriolar circulation in a case of branch retinal artery occlusion].

PURPOSE
To evaluate the retinal arteriolar circulation, morphology and sensitivity of an area in branch retinal artery occlusion (BRAO) using sequential investigation with laser Doppler velocimetry (LDV), optical coherence tomography (OCT) and microperimetry (MP-1).


CASE REPORT
A 45-year-old woman was referred for decreased vision in the right eye with a visual acuity (VA) of 0.1. At the initial examination, retinal whitening and thickening were noted in the affected area. Fluorescein angiography revealed slightly delayed retinal filling time but no obstruction of arteries. Ophthalmoscopic and fluorescein angiographic examinations revealed incomplete branch retinal artery occlusion. OCT showed retinal thickening superior to the macula. MP-1 perimetry showed scotoma in the upper macula. LDV revealed a lower absolute value of retinal arterial blood flow (RBF) (7.5 microl/min) in the right eye. Laboratory test results showed iron deficiency anemia which probably induced the BRAO. The patient was treated with ocular massage and intravenous mannitol. The next day, VA improved to 1.2 and RBF normalized to 13.9 microl/min. On follow-up 2 months after the initial visit, OCT revealed retinal thinning and inner retinal atrophy; MP-1 showed improvement in retinal sensitivity overlaying the area of branch retinal artery occlusion following resolution of retinal edema. The RBV decreased to 6.0 microl/min, showing a marked decrease due to narrowing of the artery.


CONCLUSION
In this case of acute transient BRAO, sequential LDV was performed and the quantitative retinal circulation was useful in evaluating the treatment and helped the prognosis of visual function in BRAO.