Prepapillary Vascular Loops associated with Branch Retinal Artery Occlusion and Vitreous Hemorrhage

ABSTRACT

PURPOSE: To report a case of prepapillary loops (PPLs) associated with branch retinal artery occlusion (BRAO) and vitreous hemorrhage in a patient with IgA nephropathy. METHODS: A 26-year-old woman presented with sudden loss of vision in her right eye. One year prior, she had been diagnosed as having IgA nephropathy. Examination of the right fundus revealed vitreous hemorrhage that appeared to be extending from the optic disc and a pale and edematous superior retina that was compatible with BRAO. Subretinal and intraretinal hemorrhage extending from the optic disc were also present. Laboratory tests of the factors associated with coagulation were normal. RESULTS: After spontaneous resolution of the vitreous hemorrhage and retinal edema, arterial PPLs and a venous PPL were detected at the superior portion of the optic disc. Fluorescein angiogram demonstrated slow filling of the superior branch of the retinal veins and the venous PPL. The filling of the arterial PPLs was normal and there was no delayed perfusion in the superior retina. These PPLs did not show any fluorescein leakage in the late phase of the angiogram. At the last follow-up visit, 18 months after the onset of symptoms, the vitreous hemorrhage and subretinal hemorrhage had been completely absorbed and no other ocular complications hd developed. CONCLUSIONS: PPL is usually asymptomatic; however, complications such as BRAO and vitreous hemorrhage can develop in some cases with causative factors.