{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:30Z","timestamp":1756425870786,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,26]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Pre-papillary vascular loop (PVL) is a rare congenital retinal vascular anomaly, often underdiagnosed due to its asymptomatic nature. Originating from retinal arteries or veins, PVL may lead to complications such as branch retinal artery occlusion (BRAO). This case report describes a man in his 60s presenting with sudden-onset vision loss in the left eye, diagnosed with BRAO secondary to a pre-papillary arterial loop, alongside ocular hypertension and their management. Differentiating BRAO-induced retinal nerve fibre layer (RNFL) defects from glaucomatous changes was challenging due to overlapping clinical and visual field findings. This case highlights the diagnostic complexity of PVL, particularly in distinguishing it from early glaucoma. Meticulous evaluation is crucial to avoid misdiagnosis and ensure appropriate management in such rare presentations.<\/jats:p>","DOI":"10.1136\/bcr-2025-265004","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:30:17Z","timestamp":1746750617000},"page":"e265004","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-papillary arterial loop in ocular hypertension: a rare association"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4144-1279","authenticated-orcid":false,"given":"Priyanka","family":"Ramanathan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subashini","family":"Kaliaperumal","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Stephen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6173-5073","authenticated-orcid":false,"given":"Shreyas","family":"Temkar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2025082804095063000_18.5.e265004.1","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/S0161-6420(81)34894-5","article-title":"Prepapillary vascular loops","volume":"88","author":"Degenhart","year":"1981","journal-title":"Ophthalmology"},{"key":"2025082804095063000_18.5.e265004.2","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1038\/s41433-020-0859-3","article-title":"Prepapillary vascular loop-a new classification","volume":"35","author":"Mansour","year":"2021","journal-title":"Eye (Lond)"},{"key":"2025082804095063000_18.5.e265004.3","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/0002-9394(80)90175-0","article-title":"Cilioretinal Circulation and Branch Arterial Occlusion Associated with Preretinal Arterial Loops","volume":"89","author":"Limaye","year":"1980","journal-title":"Am J Ophthalmol"},{"key":"2025082804095063000_18.5.e265004.4","doi-asserted-by":"crossref","first-page":"126","DOI":"10.4103\/0301-4738.16178","article-title":"Double prepapillary arterial loops associated with superior branch macular artery occlusion","volume":"53","author":"Vedantham","year":"2005","journal-title":"Indian J Ophthalmol"},{"key":"2025082804095063000_18.5.e265004.5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1046\/j.1442-9071.2001.d01-13.x","article-title":"Prepapillary vascular loops","volume":"29","author":"Romano","year":"2001","journal-title":"Clin Exp Ophthalmol"},{"key":"2025082804095063000_18.5.e265004.6","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/0002-9394(79)90298-8","article-title":"Preretinal arterial loops and retinal arterial occlusion","volume":"87","author":"Brown","year":"1979","journal-title":"Am J Ophthalmol"},{"key":"2025082804095063000_18.5.e265004.7","doi-asserted-by":"crossref","first-page":"212","DOI":"10.4103\/joco.joco_179_20","article-title":"Prepapillary Arterial Loop Associated with Central Retinal Artery Occlusion: A Case Report","volume":"33","author":"Susanna","year":"2021","journal-title":"J Curr Ophthalmol"},{"key":"2025082804095063000_18.5.e265004.8","unstructured":"Regenbogen L , Godel V , Spierer A , et al . n.d. Retinal arterial loop occlusion. Ann."},{"key":"2025082804095063000_18.5.e265004.9","first-page":"166","article-title":"Prepapillary vascular loop and a recurrent vitreous hemorrhage","volume":"17","author":"Strassman","year":"1997","journal-title":"Retina Phila Pa"},{"key":"2025082804095063000_18.5.e265004.10","doi-asserted-by":"crossref","DOI":"10.21037\/atm-21-5695","article-title":"The characteristics of fundus microvascular alterations in the course of glaucoma: a narrative review","volume":"10","author":"Fan","year":"2022","journal-title":"Ann Transl Med"},{"key":"2025082804095063000_18.5.e265004.11","first-page":"871","article-title":"Morphological and Quantitative Changes in Retinal and Optic Nerve Vessels in Experimental Glaucoma Model with Elevated IOP for 7 Weeks","volume":"236","author":"Mann","year":"2019","journal-title":"Klin Monbl Augenheilkd"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:01Z","timestamp":1756379401000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,8]]},"published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1136\/bcr-2025-265004"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265004","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}