PEG-LEG ARTERIOLES: AN ADAPTATION TO CHRONIC RETINAL HYPOPERFUSION

Area of Science:

• Ophthalmology
• Vascular Biology
• Neurology

Background:

• Chronic retinal hypoperfusion is a serious condition affecting vision.
• Severe bilateral occlusive disease of the carotid and vertebral arteries can lead to reduced blood flow to the brain and eyes.

Observation:

• A case report details a 42-year-old woman with a history of nasopharyngeal carcinoma and bilateral occipital infarctions.
• The patient presented with complete occlusion of common carotid arteries and proximal vertebral arteries.
• Fundus examination revealed a novel pattern of retinal vascular remodeling in both eyes.

Findings:

• Retinal arterioles exhibited a unique remodeling pattern: a narrowed proximal segment followed by abrupt dilation.
• This 'pirate's peg leg' appearance was observed in major retinal arterioles, extending peripherally.
• The vascular changes are attributed to adaptive remodeling in response to chronic hypoperfusion.

Implications:

• This newly identified sign provides a potential diagnostic indicator for chronic retinal hypoperfusion.
• Understanding this vascular remodeling may offer insights into cerebrovascular disease progression.
• Further research can explore the clinical significance and diagnostic utility of this sign in ophthalmology and neurology.