A Rare Cause of Branch Retinal Artery Occlusion in a Pregnant Woman

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Purpose: We describe a branch retinal artery occlusion (BRAO) in a pregnant woman and optical coherence tomography angiography (OCTA) as a dye-free alternative to assess retinal vasculature in this population. Methods: Serum lipids, blood sugar, carotid duplex, and transthoracic echocardiogram were collected. Fundus photography, optical coherence tomography, autofluorescence, and OCTA were used as imaging modalities. OCTA demonstrated a flow defect along a cilioretinal artery branch. Results: An atrial septal aneurysm was identified on transthoracic echocardiography. The patient was placed on anticoagulation for the duration of her pregnancy. Transesophageal echocardiogram postpartum revealed an atrial septal defect. Conclusions: Association of BRAO and atrial septal aneurysm with patent foramen ovale have not been described in pregnancy. Furthermore, OCTA has not been used in pregnancy to demonstrate retinal artery occlusion. OCTA can safely characterize retinal vasculature in pregnancy without the use of intravenous dye.

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