Old Retinal Vascular Occlusion

  • White, thready retinal vessels that look like twisted pipe cleaners
  • There is no retinal edema to indicate recent infarction because these vessels were occluded long ago
  • Many conditions cause this, including hypertension, connective tissue disease, Behçet disease, sarcoidosis
  • Patient has patchy scotomas in visual field corresponding to infarcted retina
  • Interpret this as sign of old vascular occlusion
  • Blood vessels in other body tissues are probably similarly affected but you cannot see them
  • This finding may be clue to systemic vasculopathy which, if active, will go on to destroy tissue elsewhere in body