Retinal Artery Occlusions in Healthy Children

Purpose: To describe a series of retinal arterial occlusions in healthy children. Methods: Chart review from multiple US and international institutions. Results: Five episodes affecting otherwise healthy children aged 5 to 14 are described. With the exception of migraine history in 1 individual and a novel heterozygous mutation of uncertain significance in 1 patient without clinical hyper-homocysteinemia in the methylenetetrahydrofolate reductase gene, no risk factors or systemic pathology contributing to the event were identified. Conclusion: We report a series of unilateral retinal artery occlusions in otherwise healthy children. This devastating ocular disease typically elicits an extensive ophthalmologic, radiologic, hematologic, and cardiologic evaluation, which is often unrevealing in this population. There are no evidence-based guidelines to guide the extent of diagnostic evaluation or management. Sequential bilateral artery occlusions have never been reported in otherwise healthy children.