Igawa Yuro, Ueyama Kazuhiro, Ishikawa Hiroshi, Kanno Junji, Tachibana Midori, Shinoda Kei
Department of Ophthalmology, Saitama Medical University, Saitama, JPN.
Cureus. 2025 Aug 21;17(8):e90696. doi: 10.7759/cureus.90696. eCollection 2025 Aug.
This case report describes a rare instance of central retinal artery occlusion (CRAO) in a 10-year-old girl, emphasizing the importance of electroretinography (ERG) in monitoring retinal function over time. CRAO, which is typically prevalent in middle-aged and older adults, manifests abruptly with painless vision loss and is seldom reported in the pediatric population, making this case particularly noteworthy. Unlike adults, whose CRAO often stems from atherosclerosis or emboli, pediatric cases may involve different etiologies, such as trauma or congenital defects like atrial septal defects. In this case, the patient experienced sudden vision loss in her right eye following ocular trauma. Initial examinations showed a cherry red spot and retinal swelling, with normal anterior segments and visual acuity of 0.4 in the affected eye. Over a period of six months, assessments included cone ERG, which documented a decline in both a-wave and b-wave amplitudes, indicative of progressive retinal dysfunction affecting the inner layer. Despite the retinal degeneration, the patient's visual acuity improved slightly, likely due to the collateral circulation from the ciliary artery, which is not typically affected by CRAO. This case underscores the utility of ERG in providing a comprehensive evaluation of retinal health that cannot be discerned from visual acuity alone. The findings suggest that despite the structural damage, certain retinal functions can be preserved, offering insights into potential therapeutic targets. This case adds valuable information to the limited literature on pediatric CRAO and supports the need for further research to better understand its pathophysiology and management. The role of the ciliary artery in maintaining visual function despite central retinal artery compromise is a salient area for future studies, with the potential to inform treatment strategies for preserving vision in similar cases.
本病例报告描述了一名10岁女孩罕见的视网膜中央动脉阻塞（CRAO）病例，强调了视网膜电图（ERG）在长期监测视网膜功能方面的重要性。CRAO通常在中老年人中较为常见，表现为突然无痛性视力丧失，在儿科人群中很少见，因此该病例尤为值得关注。与成年人不同，成年人的CRAO通常源于动脉粥样硬化或栓子，儿科病例可能涉及不同的病因，如外伤或先天性缺陷，如房间隔缺损。在本病例中，患者眼部外伤后右眼突然视力丧失。初步检查显示有樱桃红斑和视网膜肿胀，眼前节正常，患眼视力为0.4。在六个月的时间里，评估包括视锥细胞ERG，记录显示a波和b波振幅均下降，表明影响内层的视网膜功能逐渐衰退。尽管视网膜发生了退变，但患者的视力略有改善，可能是由于睫状动脉的侧支循环，而睫状动脉通常不受CRAO影响。本病例强调了ERG在全面评估视网膜健康方面的作用，而这仅通过视力是无法察觉的。研究结果表明，尽管存在结构损伤，但某些视网膜功能仍可保留，这为潜在的治疗靶点提供了见解。本病例为关于儿科CRAO的有限文献增添了有价值的信息，并支持进一步研究以更好地理解其病理生理学和治疗方法的必要性。睫状动脉在视网膜中央动脉受损的情况下维持视觉功能的作用是未来研究的一个重要领域，有可能为类似病例的视力保护治疗策略提供依据。
