A case of cilioretinal artery occlusion resembling hemicentral retinal artery occlusion

Hemi-central retinal artery occlusion following methanol toxicity

Objective

To describe a patient with hemi-retinal artery occlusion following methanol toxicity.

Methods

Observational case report.

Results

We report a case presented with an acute altitudinal visual field loss in the right eye following consumption of illicit alcoholic drink. In fundus photography, a well demarcated superior hemi-retinal whitening with foveal sparing was noted. Careful inspection of the optic nerve head in the right eye revealed that there was no main trunk of the central retinal artery anterior to the lamina cribrosa. Two separately emerging superior and inferior arterial trunks were noted. In fundus fluorescein angiography, earlier dye filling in the territory of the superior arterial trunk compared to the inferior arterial trunk was evident.

Conclusion

Hemi-central retinal occlusion may happen as an ocular consequence of methanol toxicity in patients with a proximal bifurcation of the central retinal artery.

Cilioretinal artery: Vasculogenesis might be promoted by plasminogen activator inhibitor-1 5G allele

BACKGROUND

Cilioretinal arteries (CAs) represent enlargements of microscopic and early established collaterals formed via vasculogenesis between choroidal and retinal circulations. We aimed to investigate whether genetic tendency to thrombosis due to well-known gene polymorphisms may induce CA vasculogenesis in embryonic life.

METHODS

We assessed plasminogen activator inhibitor-1 (PAI-1) 4G/5G, methylenetetrahydrofolatereductase (MTHFR), FACTOR V LEIDEN and PROTHROMBIN gene polymorphisms on 130 patients [82/48 females/males; Median age: 57 (18-84) with visible CAs and 100 (64/36: female/male; Median age: 55 (19-90)] without visible CAs.

RESULTS

Using multiple logistic regression models, we found PAI-1 4G/5G; MTHFR (C677T and A1298C) polymorphisms to have significant effects on the probability of visible CAs, that having at least one 5G allele would increase the odds of having visible cilioretinal artery by 98.4% [Odds ratio: 1984 (95% CI: 1.320-3.000, p = 0.001)], and having at least one MTHFR C677T or A1298C allele would decrease the odds of having visible CAs by approximately 38% (OR = 0.618, 95% CI: 0.394-0.961, p = 0.035) or 44% (OR = 0.558, 95% CI: 0.354-0.871, p = 0.011), respectively.

CONCLUSIONS

This is the first study to test the existence of significant association between presence of enlarged and visible CAs and genetic factors predisposing to thrombosis, according to the literature. Here we suggest that not only the lack of genetic predisposition to thrombosis by MTHFR gene polymorphisms, but also the PAI-1 5G allele might promote vasculogenesis of CAs.