Unilateral vascular abnormality: A case of peripheral retinal arteriolar tortuosity associated with a prepapillary vascular loop.

PURPOSE: To report a case of unilateral prepapillary vascular loop along with peripheral third order retinal arteriolar tortuosity in the same eye, and to discuss potential diagnostic considerations. OBSERVATIONS: Color fundus pictures and wide-angle fluorescein angiography (FA) demonstrated a pre-papillary vascular loop and a region of retinal arteriolar tortuosity in third order arterioles superotemporally in the left eye. The examination and ancillary testing on the right eye were normal. CONCLUSION AND IMPORTANCE: The vascular abnormality in this case does not fit a pattern present in other disease states both hereditary or acquired. The patient's immediate family do not demonstrate a similar abnormality and the patient remains visually asymptomatic upon one-year follow-up.

Current pharmacologic testing for Horner syndrome.

First described in 1727, Horner syndrome occurs from injury to one of the three neurons in the oculosympathetic pathway. Its presence can be confirmed with pharmacologic testing, traditionally including cocaine testing with hydroxyamphetamine localization. More recently, apraclonidine testing has become a viable alternative in some practices. Concern has been raised regarding the possibility of false-negative results with apraclonidine testing as well as the safety of its use in young children.