[Central retinal artery occlusion in a young man]

Central retinal artery occlusion (CRAO) is uncommon in those younger than 50. We present a 42-year-old man who complained of sudden loss of vision in the left eye. Fundus examination showed typical findings of CRAO. Extensive medical work up showed no evidence of diabetes or of cardiovascular, hematologic or collagen disease. However, a malignant tumor of the right testis was found, with metastases in the lung, retroperitoneal lymph nodes and brain. The right testis was resected and chemotherapy and brain irradiation resulted in remission during a follow-up of 2.5 years. The differential diagnosis of CRAO in younger patients is difficult. We believe that metastases from the primary tumor were the cause of CRAO in our patient. The possibility of malignancy with metastatic spread causing CRAO should be considered, particularly in relatively young patients with no other evidence of systemic disease.