Profound central visual loss and ocular neovascularization in idiopathic recurrent branch retinal arterial occlusion

The authors report a 65-year-old healthy, white man who experienced a dramatic loss of central vision. Iris neovascularization, rubeotic glaucoma, disc neovascularization and subhyaloid hemorrhage developed after multiple, recurrent, idiopathic branch retinal arterial occlusions. Vitreous and perivascular inflammation were prominent associated clinical features. Systemic steroids were useful in suppressing intraocular and perivascular inflammation, yet neither steroid nor anticoagulant therapy effectively prevented recurrent occlusive episodes. Retinal neovascularization and rubeotic glaucoma were successfully managed with scatter panretinal photocoagulation. Episodic intraocular inflammation and ocular neovascularization have been noted in one-third of patients sustaining recurrent idiopathic branch retinal arterial occlusions.