Central Retinal Artery Occlusion Masquerading as Branch Retinal Artery Occlusion

Dear Editor, Retinal artery occlusion (RAO) is characterized by attenuated arterioles and ischemic retinal opacity, which suggest retinal infarction. Branch RAO (BRAO) has a more favorable prognosis than central RAO (CRAO). CRAO and BRAO can be differentiated based on the isch-emic retinal opacity area, location of the attenuated vessels , and a cherry-red spot [1]. However, we encountered a case of CRAO masquerading as BRAO and have reported this case with a review of the relevant literature. An 81-year-old man complained of sudden visual disturbance in his right eye, which first appeared 2 days prior. The best-corrected visual acuity was hand motion. Sixty years prior, the patient's left eye had been enucleated due to ocular trauma. He was diagnosed with inferior BRAO in his right eye 6 years prior to presentation (Fig. 1A and 1B). Fundus photography revealed a supratemporal isch-emic opacity without a cherry-red spot, which indicated superior BRAO (Fig. 1C). However, fluorescein angiogra-phy (FAG) showed non-arterial filling with CRAO (Fig. Correspondence Fig. 1. (A) Fundus photograph of branch retinal artery occlusion (RAO) with an ischemic opacity at the inferotemporal lesion 6 years before presentation. (B-D) Early-to-late phase fluorescein angiography of branch RAO with non-perfusion in the inferotemporal arcade 6 years before presentation. (E) Fundus photograph of the recent central RAO with an ischemic opacity in the superior retina. (F-H) Early-to-late phase fluorescein angiography of the recent central RAO with blockage of the whole retinal artery. (I) Vertical view of spectral domain optical coherence tomography revealed an edematous retina with an ischemic opacity lesion and without any edema change in the existing branch RAO lesion.