A 38-year-old woman with neurofibromatosis type 1 presented for routine ophthalmic examination due to peripheral retinal capillary nonperfusion in the left eye. Three years earlier, fluorescein angiography had shown signs of chronic vascular abnormalities primarily in the superior retina, but an expected anterograde flow through the central retinal artery was preserved. Current fluorescein angiography revealed that the central and temporal macula was now being perfused by retrograde flow through a newly formed chorioretinal anastomosis located in a photocoagulation scar. Corrected visual acuity was maintained at 20/20 OU. The laser-induced chorioretinal anastomosis had potentially salved the macula from catastrophic ischemia due to neurofibromatosis-associated retinal arterial occlusive disease.
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