Abstract
We report a case of combined central retinal vein occlusion and branch retinal artery occlusion. A previously healthy 47-year-old male presented with decreased vision in the right eye after completing a half marathon. A fundus exam and retinal imaging revealed a combined central retinal vein and branch retinal artery occlusion.In the present report, we review the literature and discuss the possible mechanisms behind combined retinal vessel occlusions.To our knowledge, this is the first reported case of combined central retinal vein occlusion and branch retinal artery occlusion following intense exercise.
Highlights
Combined central retinal vein occlusion (CRVO) and branch retinal artery occlusion (BRAO) rarely occur together and predominantly arise in patients over 60 years of age [1]
CRVOs and BRAOs are rare in young patients
Our relatively young patient developed combined CRVO and BRAO soon after completing a half marathon. He had no previous medical or ocular history, and workup was negative for the known risk factors for vaso-occlusive diseases of the retina such as hypertension, diabetes, hyperlipidemia, hypercoagulable state, hyperviscosity state, atrial fibrillation, valve dysfunction, collagen vascular diseases, lymphoproliferative disorders, and hyperhomocysteinemia [1]
Summary
Combined central retinal vein occlusion (CRVO) and branch retinal artery occlusion (BRAO) rarely occur together and predominantly arise in patients over 60 years of age [1]. A fundus examination of the right eye revealed retinal whitening along the inferior arcade with scattered dot-blot hemorrhages near the macula and mid-periphery and dilated and tortuous veins (Figure 1A). Right eye fluorescein angiography (FA) was positive for a delayed arterial transit time in the inferior arcade artery consistent with branch retinal artery occlusion (Figure 3A, 3B). A. The right eye fundus photo shows retinal whitening along the inferior arcade with scattered dot-blot hemorrhages (white arrow), dilated and tortuous vessels. The dilated and tortuous veins, slightly delayed arteriovenous transit on fluorescein angiogram, and a few peripheral dot-blot hemorrhages of the right eye suggest that the patient had an incipient CRVO together with an inferior BRAO. He was continued on timolol bid in both eyes and was advised not to perform endurance exercises
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