This 62YO female presented with an acute counting-fingers central retinal artery occlusion. Emergent stroke workup revealed a silent acute lacunar infarct. The retinal opacification completely resolved 2 months later. New fine collateral vessels were noted on the nerve. Vision remained at counting fingers.
Learning Points:
Collateral vessels are dilated, pre-existing vessels that bypass an occlusion. These are most commonly seen at the posterior pole following retinal venous occlusions and are exceedingly rare with arterial occlusions. The endothelial tight junctions are intact, so they don’t leak angiographically. This helps differentiate them from neovascularization, which does leak.
