Cystoid Macular Edema with Idiopathic Acute Central Retinal Artery Occlusion in a Healthy Child

© 2017 Journal of ophthalmic and Vision research | published by Wolters KluWer medKnoW A 5‐year‐old girl presented to the emergency department with a 6‐day history of sudden painless vision loss in the right eye without any history of prior trauma, pain, infection, malignancy, or other known systemic diseases. Her best corrected visual acuity was no light perception (NLP) in the right eye and 20/20 in the left eye. Ophthalmic examination of the left eye was unremarkable [Figures 1b and 2b]. The right eye had relative afferent pupillary defect. Fundus examination revealed optic disc pallor, intraretinal edema at the posterior pole with a cherry‐red spot, arteriolar attenuation suggestive of central retinal artery occlusion (CRAO), and cystic changes over the macula along with resolving sub‐internal limiting membrane (ILM) hemorrhage temporal to the macula [Figure 1a]. Spectral‐domain optical coherence tomography (Cirrus HD OCT, Carl Zeiss Meditec, Dublin, CA, USA) of the right eye showed cystoid hyporeflective spaces involving the inner retinal layers at the fovea, with increased hyperreflectivity in the inner retina secondary to the ischemic changes [Figure 2a]. Full‐field electroretinography revealed delayed and reduced amplitude of scotopic and photopic responses in the right eye [Figure 3]. Systemic investigations, including a complete hemogram with erythrocyte Cystoid Macular Edema with Idiopathic Acute Central Retinal Artery Occlusion in a Healthy Child