[Bilateral sequential central retinal vein occlusion associated with primary antiphospholipid syndrome]

Case report of a young female patient presenting with bilateral sequential central retinal vein occlusion associated with primary antiphospholipid syndrome (APS), which rapidly improved with systemic anticoagulation.

A complete ophthalmologic examination and hematological evaluation were performed on an 18-year-old female patient presenting with unilateral decreased visual acuity in the left eye, secondary to a central retinal vein occlusion. Three years later, she experienced a central retinal vein occlusion of the right eye. Hematologic evaluation revealed primary antiphospholipid syndrome. The patient was treated with systemic anticoagulation.

One month after the diagnosis and treatment of the central retinal vein occlusion in the left eye, the patient discontinued anticoagulant therapy, unfortunately resulting in severe visual loss. Three years later, upon recurrence in the fellow eye, systemic anticoagulation was reinstituted. Over 12 months follow-up, upon complete ophthalmologic examination, the patient showed normalization of all retinal signs.

In the case of young patients with bilateral central retinal vein occlusions, hematologic evaluation should be performed so as to detect APS. Prompt, effective treatment is necessary to prevent further retinal damage. Recurrent thrombotic events may jeopardize anatomic and functional prognosis.