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Ophthalmology
Pre-papillary arterial loop in ocular hypertension: a rare association
  1. Priyanka Ramanathan1,
  2. Subashini Kaliaperumal2,
  3. Mary Stephen1 and
  4. Shreyas Temkar1
  1. 1Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Puducherry, India
  2. 2Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
  1. Correspondence to Dr Subashini Kaliaperumal; subadoc{at}gmail.com

Abstract

Pre-papillary vascular loop (PVL) is a rare congenital retinal vascular anomaly, often underdiagnosed due to its asymptomatic nature. Originating from retinal arteries or veins, PVL may lead to complications such as branch retinal artery occlusion (BRAO). This case report describes a man in his 60s presenting with sudden-onset vision loss in the left eye, diagnosed with BRAO secondary to a pre-papillary arterial loop, alongside ocular hypertension and their management. Differentiating BRAO-induced retinal nerve fibre layer (RNFL) defects from glaucomatous changes was challenging due to overlapping clinical and visual field findings. This case highlights the diagnostic complexity of PVL, particularly in distinguishing it from early glaucoma. Meticulous evaluation is crucial to avoid misdiagnosis and ensure appropriate management in such rare presentations.

  • Lasers
  • Retina
  • Glaucoma

https://doi.org/10.1136/bcr-2025-265004

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    Footnotes

    • X @ShreyasTemkar

    • Contributors All the authors have equally contributed to patient’s management, text drafting, editing of text, obtaining clinical images and final revision of the draft. Final approval of the manuscript was given by SK. SK is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.