Salmon-patch hemorrhages after central retinal artery occlusion in sickle cell disease

ABSTRACT

In two patients with sickle cell disease (one hemoglobin SC and one hemoglobin SS), central retinal artery occlusion developed. In one case, the occlusion followed a retrobular injection of lidocaine hydrochloride. Although the central retinal artery reperfused in each patient, many secondary peripheral retinal ateriolar occlusions remained. During the subsequent days, multiple salmon-patch hemorrhages developed in the distribution of these occluded arterioles. In one patient, the salmon-patch hemorrhages evolved into atrophic schisis cavities. These unusual cases allowed us to document the origin of salmon-patch hemorrhages after peripheral retinal arteriolar occlusions. The development of the hemorrhages was a delayed phenomenon that occurred hours to days after the initial vascular occlusion. Reperfusion of the damaged ischemic vessels with a blowout of the walls of the vessels seems the most likely explanation for this phenomenon. (Au)