Retinal Vascular Tortuosity

This patient presented with asymptomatic bilateral retinal venous and arterial vascular tortuosity. There was no significant past medical or family history.

Learning Points:
This appearance must be differentiated from acquired retinal vascular tortuosity caused by retinal venous occlusive disease, hyperviscosity (polycythemia, dysproteinemia, leukemia etc.), Fabry’s disease, and fetal alcohol syndrome.

Familial retinal arteriolar tortuosity, a rare autosomal dominant disorder, affects the macular and peripapillary second and third order arterioles, and can rarely develop symptomatic vitreous hemorrhage (see Sutter and Helbig Surv Ophthalmology 2003;48:245-255).