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Comment & Response
March 2015

Prepapillary Vascular Loop

Author Affiliations
  • 1Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
JAMA Ophthalmol. 2015;133(3):362. doi:10.1001/jamaophthalmol.2014.5047

To the Editor I was intrigued to read the case of trauma-induced prepapillary arterial loop torsion producing retinal arterial occlusion in a young person, but will politely contest the authors’ claim that this is the first such report.1

A 1993 article documented entirely similar findings in a young woman who was struck in the head while swimming.2 She developed obscuration in a sector of vision 15 minutes after the episode. Torsion of a prepapillary arterial loop from the blunt trauma was proposed as the mechanism of arterial occlusion. The features were demonstrated on fluorescein angiography. In that case there was no vitreous detachment.