Central retinal vein occlusion after intense exercise in healthy patients

To report a case-series of central retinal vein occlusion that occurred in young, healthy patients after periods of intense exercise.

Retrospective chart review.

Seven eyes of six patients with central retinal vein occlusion after exercise were assessed. Visual acuity, intraocular pressure, and physical examination evidence of neovascularization were recorded on presentation and follow-up visits. Some patients had optical coherence tomography done on both initial and final visits and some had only one optical coherence tomography performed. One eye had no light perception at the time of diagnosis and was excluded from statistical calculations involving visual acuity.

Patients were all males without any significant medical history. All patients had complete blood work, including hypercoagulable workup. Results were normal and no underlying cause was ever identified. Mean age was 37.6 years. The mean duration of symptoms before examination was 12.4 weeks. The average time that patients were observed was 170 days. On presentation, the average logarithm of the minimum angle of resolution value and standard deviation of visual acuity were 0.113 ± 0.198. The decimal acuity at this time was 0.83 ± 1.98 lines with the Snellen equivalent of 20/28.33 ± 1.92 lines. The average logarithm of the minimum angle of resolution value and standard deviation of final visual acuity were 0.081 ± 0.179. The decimal acuity was 0.9 ± 1.79 lines and the Snellen equivalent was 20/25.6 ± 1.79 lines. Mean intraocular pressure was 16.9 with standard deviation of 6.025. Range of intraocular pressure was 7 to 30 mmHg. Central retinal thickness as measured by optical coherence tomography ranged from 200 to 700 μm. No complication developed as a result of central retinal vein occlusion during the follow-up period.

Central retinal vein occlusion may occur in young, healthy patients after intense exercise. The exact precipitating event is unknown, but may be a combination of factors, including transiently increased intravascular and intraocular pressure, dehydration, and increased blood viscosity.