# Branch retinal artery occlusion in a young woman with papilledema and a prepapillary vascular loop

## TL;DR

A young woman with optic disc swelling and a vascular loop developed a retinal artery blockage, which was initially missed but later detected during follow-up.

## Contribution

This case highlights the diagnostic challenge of BRAO in patients with papilledema and prepapillary vascular loops.

## Key findings

- A 22-year-old woman presented with visual field loss and bilateral optic disc edema.
- A BRAO was detected in the left eye during follow-up, alongside prepapillary vascular loops.
- The visual field defect improved over time despite initial misattribution to papilledema.

## Abstract

To report a case of a branch retinal artery occlusion (BRAO) associated with a prepapillary vascular loop in a patient with papilledema.

A 22-year-old woman presented with sudden superior visual field loss in the left eye. Initial examination demonstrated mild optic disc edema bilaterally. The diagnosis of idiopathic intracranial hypertension was made and treatment with acetazolamide was initiated. During follow-up examination bilateral prepapillary vascular arterial loops and a BRAO in the left eye were diagnosed. Over time the initially dense superior arcuate visual field defect improved.

We report a case of BRAO and prepapillary loops in a patient with coexisting papilledema. The initial symptoms of unilateral visual field loss were falsely attributed to the presence of papilledema and the BRAO was only detected on subsequent examination. The case highlights the importance of correlating the presenting chief complaint with the examination findings to reach the correct diagnosis.