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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

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Polycythemia causing posterior segment vascular occlusions.

Suganeswari Ganesan¹, Rajiv Raman¹, Tarun Sharma¹

¹Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.

Oman Journal of Ophthalmology

|March 17, 2017

Summary

This summary is machine-generated.

Polycythemia vera (PV) can present with transient and permanent central retinal artery occlusion (CRAO), leading to vision loss. Early diagnosis and treatment of PV are crucial to prevent recurrent thromboembolic events and preserve sight.

Keywords:

Amalric sign central retinal artery occlusion lateral posterior ciliary artery occlusion polycythemia

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Area of Science:

Ophthalmology
Hematology
Vascular Medicine

Background:

Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by increased red blood cell mass, predisposing patients to thrombotic and hemorrhagic complications.
Ocular vascular occlusions, including central retinal artery occlusion (CRAO), can be a rare but presenting manifestation of PV.

Observation:

A 44-year-old male with PV experienced transient CRAO with ocular ischemic symptoms but normal transit times.
He later presented with permanent CRAO, choroidal infarct (Amalric's sign), and vision loss, indicating progression and additional vascular involvement.

Findings:

The patient exhibited diagnostic features of polycythemia vera.
The ocular findings progressed from transient to permanent CRAO and lateral posterior ciliary artery occlusion, consistent with multifocal thromboembolic events.
Amalric's sign (choroidal infarct) was observed during the second presentation, indicating severe ischemia.

Implications:

This case highlights that ocular vascular events can be the initial presenting feature of PV.
Prompt diagnosis of PV and aggressive management of hematologic parameters are essential to prevent severe visual morbidity.
Ophthalmologists should consider hematologic evaluation in patients presenting with unexplained CRAO, especially with risk factors for PV.