Objective: To report a case of cilioretinal artery occlusion with angiographic findings characteristic of the "string of beads" associated with renovascular hypertension secondary to fibromuscular dysplasia of the renal artery in a child.
Design: Case report.
Intervention: The patient underwent ex vivo renal artery reconstruction with saphenous vein graft and reimplantation.
Main outcome measures: The main clinical outcomes were control of severe hypertension, reversible hypertensive retinopathy, and improvement of vision.
Results: Revascularization of the kidney improved renal function, and renovascular hypertension was clearly improved. Visual acuity improved to 20/200.
Conclusions: A child with hypertensive retinopathy and arterial occlusion in the retina should undergo investigation to rule out a surgically curable hypertension. Magnetic resonance angiography of extrarenal vessels may reveal other sites of involvement of fibromuscular dysplasia. Evaluation and early diagnosis of renovascular hypertension will prevent severe end-organ damage.