Acute obstruction of the retinal and choroidal circulations

The cases of eight patients (10 eyes) with the equivalent of an acute ophthalmic artery obstruction (simultaneous impairment of both the retinal and choroidal circulations) are described. Ophthalmoscopic features included intense opacification of the retina in the posterior pole; variable absence of a cherry red spot, and the subsequent development of optic atrophy and pigment epithelial changes. Fluorescein angiographic signs encompassed delayed retinal and choroid filling, as well as leakage at the level of the retinal pigment epithelium (RPE). Electroretinography (ERG) disclosed absence of both the a- and b-waves. The entity carries a grim visual prognosis, as all ten eyes initially had no perception of light; improvement to light perception occurred in one instance.