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Branch retinal artery occlusion — SCE Neurology MCQ

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ModerateStrokeBranch retinal artery occlusionSCE Neurology

A 42-year-old woman presented with sudden painless sectoral visual field loss in one eye. On examination, fundoscopy showed retinal whitening along an arterial branch. Initial investigations showed: carotid imaging revealed ipsilateral plaque but brain MRI was negative. Where is the most likely anatomical localisation?

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Correct answer: E — retinal branch arteriole

retinal branch arteriole is the best answer because the vignette describes Branch retinal artery occlusion: retinal arterial occlusion is an ischaemic vascular event requiring stroke-style work-up. Superior sagittal sinus is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Contralateral internal capsule and Periventricular white matter are less appropriate because they would require different localisation, timing or test findings; Subarachnoid space would fit a different syndrome. Clinical pearl: optic neuritis is painful with colour desaturation and different fundoscopy.

Reference: NICE NG128; National Clinical Guideline for Stroke; DVLA Assessing fitness to drive