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Hemi-central retinal artery occlusion in young adults

Chopdar, Amresh

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Indian Journal of Ophthalmology: May–Jun 2011 - Volume 59 - Issue 3 - p 261-262
doi: 10.4103/0301-4738.81033
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Dear Editor,

I read the article with interest on hemi-central retinal artery occlusion in young adults by Rishi et al.[1]

This condition is unlikely to occur on ground of embryology, as the central retinal artery develops from a single hyaloid artery and enters the lamina cribrosa, and divides further into its principal branches. However, one may have a hemi-central retinal vein occlusion because two veins develop on either side of the hyaloid artery, which exit from the lamina cribrosa after joining to form a single central retinal vein. Occasionally, they may not come closer to unite and exit the lamina cribrosa separately, thus creating two central retinal veins.[24] The clinical pathology produced by such an anomaly has been extensively reported.[5] These cases reported here is early branching of the central retinal artery prior to its entry through the lamina cribrosa. In case 1, Fig. 1 shows associated choroidal infarct of the upper half of the fundus. Fig. 2 shows that the upper artery is a cilioretinal artery, whereas the lower one is the true central retinal artery. The fluorescein angiography in Fig. 3 shows the upper artery brighter than the lower, indicating that this is an earlier branch. Cases 2–4 are identical to case 1 and all of them are associated with choroidal and retinal ischemia.

1. Rishi P, Rishi E, Sharma T, Mahajan S. Hemi-central retinal artery occlusion in young adults Indian J Ophthalmol. 2010;58:425–32
2. Mann I The development of human eye. 19643rd ed London British Medical Association:128
3. Hayreh SS, Hayreh MS. Hemi central retinal vein occlusion, abstracted Invest Ophthalmol Vis Sci. 1979;18(ARVO suppl):170
4. Chopdar A. Dual trunk central retinal vein Incidence in clinical practice Arch Ophthalmol. 1984;102:85–7
5. Chopdar A. Hemi central retinal vein occlusion, pathogenesis, clinical features, natural history and incidence of dual trunked central retinal vein Trans Ophthalmol Soc U K. 1982;102:241–8
© 2011 Indian Journal of Ophthalmology | Published by Wolters Kluwer – Medknow