This healthy 25YO male presented with 3 weeks of vision loss in his left eye from active idiopathic central serous chorioretinopathy (ICSC). Vision was 20/20 in his normal OD and 20/110 OS.
A cilioretinal vessel originates within the inferotemporal aspect of the nerve and arches inferiorly. Fluorescein angiography reveals that this cilioretinal artery supplies the entire inferotemporal retina. Color imaging of the macula shows a large serous detachment with some drusen-like changes. This detachment is confirmed on OCT scanning. A blot leak is seen angiographically. Due to the patient’s symptoms, thermal laser was applied to the angiographic leak.
Learning Points:
The inner two-thirds of the neurosensory retina are supplied by the central retinal artery, with the choroid supplying the RPE and photoreceptor layer. Cilioretinal arteries, which arise from the posterior choroidal circulation, are present in up to 50% of individuals and are bilateral in about 25% (Schneider et al, Acta Ophthalmologica 2021;99:e310-e318).
