Branch retinal artery occlusion as an acute complication of coronary angiography

Introduction
Retinal artery occlusion (RAO) is one of the rare complications of intravascular procedures. It is most often caused by atheromatous plaque material moved from the aortic arch or carotid artery wall as a result of mechanical manipulation.

Case report
We report a case of a 70-year-old man, who presented with vision deterioration in his right eye (RE) during coronary angiography (CAG). Computed tomography (CT) scan of the patient’s brain was unremarkable. The patient was subsequently referred to the Department of Ophthalmology. On admission, the best-corrected visual acuity (BCVA) was hand motions in the RE. He had a relative afferent pupillary defect and posterior segment examination revealed pale macula with cherry red spot as well as embolic material in the lower vascular arch in the RE. Ocular massage and an anterior chamber paracentesis were performed. Fundus fluorescein angiography (FFA) confirmed the lack of perfusion through the lower temporal branch of the right central retinal artery, and partial return contrasting of this vessel in late phases was described. This clinical picture suggested lower temporal branch right retinal artery occlusion (BRAO).

Conclusions
Intravascular procedures, including CAG, may result in RAO. Awareness of the possibility of ocular symptoms during and after the surgery, early diagnosis and initiating appropriate treatment are crucial in preventing permanent visual impairment.