Posterior segment neovascularization associated with acute ophthalmic artery obstruction

Purpose: To report previously unrecorded ocular neovascularization associated with acute ophthalmic artery obstruction (AOAO) that presents clinical manifestations of acute concomitant obstruction of the retinal and posterior ciliary circulations. Methods: This report documents the clinical, fluorescein angiographic, and histopathologic findings in two patients with AOAO followed by posterior segment neovascularization. Results: Ophthalmoscopic findings showed whitening of the posterior pole, arterial attenuation, and a pale optic disk. Serial fluorescein angiograms showed a nearly total shutdown of choroidal and retinal perfusion, degeneration of the retinal pigment epithelium and choriocapillaris, and eventual development of a huge neovascular frond at the posterior pole. Histopathologic examination of the enucleated eyeball showed inner retinal necrosis caused by central retinal artery obstruction, degeneration of the outer retina with choriocapillaris obstruction caused by impairment of choroidal circulation, and a thick preretinal neovascular frond at the posterior pole. Conclusions: These results suggest that AOAO can induce ocular neovascularization, which to the authors' knowledge has not yet been reported.