This 73YO male presented with acute inferotemporal visual field loss.
Optos imaging shows an acute extramacular branch retinal artery occlusion (BRAO) caused by a likely platelet-fibrin embolus just superonasal to the optic nerve. The distal retina is somewhat opaque, and the blood column is stagnant superiorly.
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 (Biousse et al, Ophthalmology 2018;125:1597-1607).
