Pre-papillary arterial loop in ocular hypertension: a rare association

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Case Reports

Background:

• Pre-papillary vascular loops (PVL) are rare congenital retinal vascular anomalies.
• PVL often remain asymptomatic and underdiagnosed.
• PVL can lead to serious complications like branch retinal artery occlusion (BRAO).

Purpose of the Study:

• To report a case of branch retinal artery occlusion (BRAO) secondary to a pre-papillary arterial loop (PVL).
• To discuss the diagnostic challenges in differentiating PVL-induced retinal nerve fibre layer (RNFL) defects from glaucoma.
• To highlight the importance of meticulous evaluation in managing rare vascular anomalies.

Main Methods:

• Case report of a male patient in his 60s with sudden vision loss.
• Diagnostic evaluation included assessment for ocular hypertension and RNFL defects.
• Clinical and visual field findings were analyzed to differentiate BRAO from glaucoma.

Main Results:

• The patient was diagnosed with BRAO secondary to a PVL, accompanied by ocular hypertension.
• Distinguishing RNFL defects caused by BRAO from glaucomatous changes proved challenging due to overlapping signs.
• Appropriate management strategies were implemented for the diagnosed conditions.

Conclusions:

• Pre-papillary vascular loops can cause significant visual complications like BRAO.
• Differentiating PVL-related findings from glaucoma requires careful clinical assessment.
• Timely diagnosis and management are crucial for rare retinal vascular anomalies to prevent vision loss.