Branch Retinal Artery Occlusion in a Young Adult: A Diagnostic Clue to Systemic Embolic Risk

Branch retinal artery occlusion (BRAO) is characterized by the blockage of one or more of the smaller branches of the central retinal artery, resulting in localized retinal ischemia and potential abrupt vision impairment. Typically occurring in older adults, BRAO is frequently linked to embolic events originating from carotid or cardiac sources, such as cholesterol or calcific plaques. Conversely, BRAO in younger individuals is uncommon and often indicates an atypical systemic etiology. Cardiac conditions, including valvular disease and replacement heart valves, have been documented as embolic sources in such instances. This case report details a 41-year-old woman with a prior history of a mechanical aortic valve replacement who developed chronic BRAO potentially attributed to a suspected calcific embolus. Her evaluation revealed a calcific embolus causing inferior temporal BRAO with corresponding visual field loss and inner retinal atrophy. She was co-managed with a systemic stroke workup, cardiology, resulting in warfarin dose adjustment, and reported stable vision at six-month follow-up.