From blindness to light: A clinical conundrum - central retinal vein occlusion as an initial manifestation of inflammatory bowel disease

Abstract

This case report emphasizes central retinal vein occlusion (CRVO) as the primary cause of blindness, typically linked to impaired retinal venous drainage from critical vein obstruction. While conditions like diabetes and hypertension are known risk factors for CRVO, rare instances associate it with inflammatory bowel disease (IBD). Here, a 19-year-old male initially presented with painless vision loss, revealing ocular ischemia secondary to panuveitis and moderate CRVO. Genetic testing indicated HLA-B51/B52, suggesting Behcet's disease initially, treated with immunosuppressants and steroids. Despite initial recovery, severe gastrointestinal symptoms later led to ulcerative colitis diagnosis. This sequence highlights CRVO preceding IBD symptoms in a high-risk individual, prompting caution in its differential diagnosis, especially in younger patients without typical risk factors. Prompt recognition and a collaborative approach between gastroenterologists and ophthalmologists are crucial for improving patient outcomes.