Bilateral retinal branch vascular occlusion-a first presentation of crohn disease

To describe a case of Crohn disease presenting as a branch retinal artery occlusion in one eye and branch retinal vein occlusion in the other eye as a first presentation.

Case report.

A 34-year-old man presented with simultaneous left superotemporal branch retinal artery and right superotemporal branch retinal vein vasculitic occlusion in the absence of other signs of intraocular inflammation. Extensive investigations over 6 months directed primarily at vasculitides, coagulopathies, and atypical infections failed to reveal the underlying diagnosis. A subsequent presentation with gastrointestinal manifestations led to a colonic biopsy and the diagnosis of Crohn disease. A combination of azathioprine and low-dose steroids was effective in the maintenance of remission of this disorder.

Inflammatory bowel disease should be considered in the differential diagnosis of retinal vascular occlusive disorders in young patients. Combination therapy with systemic steroids and azathioprine are effective for maintenance of remission and prevention of ocular complications.