This Ophthalmic Image describes a case of central retinal artery occlusion with patent cilioretinal artery in a woman in her 30s.

A 35 year old female presented with sudden painless decrease of vision in her right eye. Visual acuity in her right eye was 6/12 on distant Snellen’s acuity chart. A relative afferent pupillary defect was noted. Fundus examination in right eye showed optic disc swelling, retinal opacification and retinal edema with a perfused area of retina (Figure 1, arrowhead) at posterior pole suggestive of central retinal artery occlusion with patent cilioretinal artery. A detailed medical history revealed that she had taken a dose of depot progesterone three months back for contraception. Complete haemogram, coagulation profile and lipid profile was normal. Carotid Doppler showed presence of a thrombus in right internal carotid artery for which she is under care of cardiologist. Central retinal artery occlusion with a patent cilioretinal artery presents with constriction of visual fields but central vision is preserved.

Figure 1: Fundus photograph of Right eye shows the presence of disc edema with mild hyperemia of the optic disc. Retina is edematous and opacified with loss of normal sheen, there is an area of normal retina at posterior pole with normal perfusion (arrowhead) corresponding to the circulation of cilioretinal artery.