Abstract

P 192

Hourglass-like narrowing of the inferior temporal retinal artery as a cause of ipsilateral subcapsular cataract in a young patient

Kawa Khoshnaw, Zisis Gatzioufas, Ursula Löw, Nikolaos Kozeis, Frank Schirra, Berthold Seitz
Klinik für Augenheilkunde, Universitätskliniken des Saarlandes, Homburg/Saar

Introduction
Metabolic or ischemic conditions such as diabetes, therapy with corticosteroids, trauma or relevant carotid stenosis may cause cataract formation in younger patients. We report on a young patient with a focal narrowing of inferior temporal branch retinal artery (BRA) which developed focal subcapsular cataract.
Patient and methods
A 42-year-old patient presented with visual impairment in the right eye (OD). Medical and drug history was empty. There was no trauma. Best corrected visual acuity (BCVA) OD: 0.4; OS: 0.8. Anterior chamber was regular and uninflammed by slitlamp examination with clerar media on both sides except for focal posterior subcapsular cataract OD. IOD was normal OU. A carotid artery stenosis was excluded by Doppler Sonography.  Binocular ophthalmoscopy showed a focal narrowing of the inferior-temporal BRA, which was confirmed with fluorescent dye angiography. Blood flow was investigated and visualised in ten different horizontal levels in the inferior-temporal vascular region of interest by comparing both eyes with the aid of HRF (Heidelberg Retinal Flowmetry).
Results
By HRF a clearly reduced blood flow in the inferior-temporal BRA OD was measured, i.e. 288.4±33.7 A.U versus 426.76±39.1 in the corresponding left eye vascular area, (z test, p<0.005). One week after uneventful cataract surgery BCVA was 0.9 OD.
Conclusion
Since no obvious other causes of cataract are present, we postulate that substantial focal narrowing of a branch of the central retinal artery might be a potential trigger for premature subcapsular cataract formation. Visual prognosis is favourable.

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