J Retin.  2023 Nov;8(2):144-149. 10.21561/jor.2023.8.2.144.

Three Cases of Central Retinal Vein Occlusion Associated with Systemic Disease: Case Report

• Koh EJ
• Bang JW
• Lee DH
• Lee JH
• Chang JW
• Chung IK
• Song Mk
• Choi HJ

• KMID: 2552106
• DOI: http://doi.org/10.21561/jor.2023.8.2.144

Abstract

Purpose
To report three cases of central retinal vein occlusion (CRVO) in patients with unusual systemic diseases.
Case summary
The first case involves a 51-year-old male who presented with reduced vision in both eyes. Examination revealed retinal hemorrhage, vascular tortuosity, Roth spots. During the systemic examination conducted under the diagnosis of CRVO, the patient was diagnosed with multiple myeloma, and received chemotherapy and underwent plasma exchange for hyperviscosity syndrome. In the second case, a 56-year-old man visited with decreased vision in his right eye, and showed retinal hemorrhage, vascular tortuosity, and macular edema. He received a diagnosis of CRVO attributed to primary antiphospholipid syndrome and was treated by oral aspirin and intravitreal bevacizumab injection. In the third case, a 21-year-old woman reported decreased vision in her left eye, and displayed retinal hemorrhage, vascular tortuosity and optic disc swelling. The patient was diagnosed with CRVO and underwent cerebral angiography at the neurology and neurosurgery departments. A left carotid cavernous fistula (CCF) was identified, but the symptoms improved, so the patient was kept under observation.
Conclusions
Additional examinations confirmed multiple myeloma, antiphospholipid antibody syndrome, and CCF in patients who initially presented with CRVO. It is necessary to investigate the underlying disease in individuals with CRVO as their primary clinical manifestation.

Keyword

Antiphospholipid syndrome; Carotid-cavernous sinus fistula; Multiple myeloma; Retinal vein occlusion