PRAXIS OF COMPLEX OCULAR COMORBIDITIES: CLINICAL MANIFESTATION OF CENTRAL RETINALARTERY OCCLUSION (CRAO) IN A PATIENT WITH DIABETIC RETINOPATHY (DR

POSTER PRESENTATIONS

Introduction. CRAO manifests as unilateral inner retinal swelling associated with a cherry-red spot. Non-proliferative diabetic retinopathy (NPDR) is characterized by bilateral increased micro-vascular permeability, often associated with dot and blot hemorrhages, lipid exudates and micro-aneurysms. Although both entities have been well established in the literature, we report a rare case of simultaneous presentation in a relatively young patient. Case Report. A 47-year old black male presented with sudden painless vision loss in his right eye x 5 days. Medical history revealed HTN and DM. BVA was LP OD and 20/20 OS. Pupils revealed APD OD. DFE OD revealed scattered dot and blot hemorrhages, flame-shaped hemorrhages and exudates in the posterior pole, whitish areas of intra-retinal edema associated with a cherry red spot were noted in the posterior pole. DFE OS revealed scattered dot hemorrhages with hard exudates. The initial clinical impression was NPDR OU in addition to CRAO OD. Discussion. Due to the overall clinical picture, the patient was asked to seek medical care for further evaluation, to include Carotid Doppler, echocardiogram, CBC with differentials, Sickledex (Streck), re-evaluation of FBS and HbA1C. In addition, the patient was asked to get a fluorescein angiography due to the likelihood that decreased choroidal perfusion attributed to the severe vision loss. Conclusion. CRAO and diabetic retinopathy presenting concomitantly in the same eye, may attribute to a diagnostic predicament. This rare case highlights the importance of establishing a complete diagnosis that is crucial to provide appropriate and prompt medical work-up and management