Unilateral vascular abnormality: A case of peripheral retina
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A 16-year old visually asymptomatic female with no significant past medical or surgical history was referred to our retina group practice for the evaluation of a retinal vascular abnormality in the left eye detected on a routine eye exam. The patient did not have a history of perinatal or postnatal medical problems and was born at term.

Visual acuity was 20/20 in each eye, and intraocular pressures were 19 mmHg and 18 mmHg for OD and OS, respectively. Anterior segment examination was unremarkable OU. Posterior segment exam was normal OD, but in the OS, a prepapillary vascular loop and focal superotemporal arteriolar tortuosity were discovered. Wide-angle fluorescein angiography showed multifocal third-order arteriolar tortuosity in the superotemporal periphery OS, with hairpin turns and corkscrew characteristics (Fig. 2, A-B, curved arrows). There was delayed AV transit within the tortuous superotemporal arterioles. The prepapillary vascular loop was in a different distribution, associated with the inferior hemiretinal branch artery. The distal portions of the inferotemporal retinal vein crossed well over the horizontal meridian (straight arrow). This is likely of less significance, and similar crossing of the superotemporal arcade artery was noted OD. There was otherwise normal microcirculation without vascular leakage or occlusion.

Examination and imaging of the patient's two male siblings as well as both parents were without notable retinal findings. The patient underwent magnetic resonance imaging of the head and neck with and without contrast, which was unremarkable.