This is an 80YO female who presented with a branch retinal arterial occlusion (BRAO) and 20/40 vision.
The causative calcific embolus is seen overlying the inferior optic nerve. The opaque retina is especially well visualized with the Optos green channel but virtually invisible in the Optos red channel.
The vertical B-scan contrasts the normal superior retina with the ischemic inferior retina (marked hyperreflectivity of the inner retina, causing shadowing of the outer retina and choroid).
Learning Points:
This patient had acute retinal ischemia (defined as acute BRAO, central retinal artery occlusion, or transient monocular vision loss) and was immediately referred to the nearest stroke center, which is the standard of care.
