[Arterial ocular occlusion associated with systemic venous thrombophilia--2 case reports]

Arterial ocular occlusions in apparently healthy young men are unusual. Because of inconsistent study results there is a great amount of insecurity with respect to the reasonable diagnostic approach in such a scenario. We report on the process of diagnostic steps in two young men with arterial ocular occlusion such as non-arteritic optic neuropathy (NAION) and branch retinal arterial occlusion (BRAO).

Here, we report on two hitherto healthy young men who suffered from ocular arterial occlusions. Because of the apparent arterial perfusion deficit at first thrombocyte aggregation-inhibiting substances were recommended. On searching for the underlying embolic source in both men a significant arterial-venous cardiac and pulmonary shunt volume was identified. Additional screening for risk factors for venous thrombosis resulted in the identification of Factor V Leiden as well as hyperhomocysteinemia.

These two cases stress the importance to exclude possible arterial-venous shunts and, if identified, the need to search for additional risk factors for venous thrombosis in patients with arterial embolic ocular disease.