A middle hyper-reflective band on spectral domain optical coherence tomography in a case of acute nonarteritic central retinal artery occlusion with sparing of cilioretinal artery.

An 80-year-old female presented with sudden decreased vision in the right eye (RE) since 6 h. Posterior segment examination of RE showed signs suggestive of nonarteritic central retinal artery occlusion (CRAO) with sparing of cilioretinal artery (CLRA) [Fig. 1a and b]. Spectral domain optical coherence tomography (SD OCT) done in macular area showed a middle hyper-reflective band (MHB) in the temporal perifoveal area and increased reflectivity of the inner retinal layers suggestive of ischemia.[12] The nasal perifoveal area showed normal inner retinal structure, without MHB, suggesting sparing of CLRA [Fig. 1c]. The presence of MHB on SD OCT can aid in the diagnosis and provide prompt and noninvasive clue to the diagnosis of acute CRAO with sparing of ciliroretinal artery (CLRA).

Figure 1

Color fundus photo (a) and red free (b) showing retinal whitening suggestive of CRAO and CLRA (red arrows). The Corresponding OCT (c) passing through the fovea (green arrow- Fig. 1a) shows hyper-reflectivity of inner retina layers and MHB on temporal perifoveal area (black arrow- Fig. 1c) and normal inner retinal architecture nasal to fovea with absence of MHB

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