Functional Assessment Over Time Using Electroretinograms: A Case Report of a Pediatric Patient With Central Retinal...

This case report describes a rare instance of central retinal artery occlusion (CRAO) in a 10-year-old girl, emphasizing the importance of electroretinography (ERG) in monitoring retinal function over time. CRAO, which is typically prevalent in middle-aged and older adults, manifests abruptly with painless vision loss and is seldom reported in the pediatric population, making this case particularly noteworthy. Unlike adults, whose CRAO often stems from atherosclerosis or emboli, pediatric cases may involve different etiologies, such as trauma or congenital defects like atrial septal defects. In this case, the patient experienced sudden vision loss in her right eye following ocular trauma. Initial examinations showed a cherry red spot and retinal swelling, with normal anterior segments and visual acuity of 0.4 in the affected eye. Over a period of six months, assessments included cone ERG, which documented a decline in both a-wave and b-wave amplitudes, indicative of progressive retinal dysfunction affecting the inner layer. Despite the retinal degeneration, the patient's visual acuity improved slightly, likely due to the collateral circulation from the ciliary artery, which is not typically affected by CRAO. This case underscores the utility of ERG in providing a comprehensive evaluation of retinal health that cannot be discerned from visual acuity alone. The findings suggest that despite the structural damage, certain retinal functions can be preserved, offering insights into potential therapeutic targets. This case adds valuable information to the limited literature on pediatric CRAO and supports the need for further research to better understand its pathophysiology and management. The role of the ciliary artery in maintaining visual function despite central retinal artery compromise is a salient area for future studies, with the potential to inform treatment strategies for preserving vision in similar cases.