A 76-year-old patient presented with a reduced visual acuity of 0.8. The clinical examination revealed rubeosis iridis and dilated retinal veins. In fluorescein angiography peripheral retinal ischemia could be observed and panretinal laser coagulation was immediately started. A comprehensive internistic counselling on the risk factors particularly for ocular ischemic syndrome was refused by the patient. Over time there was a progression of loss of visual acuity to complete visual loss. Magnetic resonance angiography revealed a profound stenosis of the internal carotid artery with complete closure of the left ophthalmic artery and percutaneous transluminal angioplasty was performed in vascular surgery.
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