Spontaneous internal jugular vein thrombosis and venous-stasis retinopathy

A case is presented in-which the detection of venous-stasis retinopathy in one eye led to investigation of the carotid circulation. There were no neurologic symptoms of carotid insufficiency, and noninvasive tests failed to reveal significant carotid pathology. Digital subtraction angiography and carotid angiography demonstrated a carotid plaque of doubtful significance. At carotid endarterectomy, the venous-stasis retinopathy was found to be associated with venous thrombosis distant from the eye and in the internal jugular vein. This site is beyond the range over which isolated ocular vascular effects would be expected and was thought to be unrelated to the hemodynamically insignificant, nonulcerated carotid artery plaque. The possibility of this association being causal is discussed.