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Updated: Sep 14, 2025
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Optimization of the Retinal Vein Occlusion Mouse Model to Limit Variability
Published on: August 6, 2021
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Persistent central retinal vein occlusion (CRVO) in protein S and C4b complement deficiency
Rama Tulasi Siri Duddumpudi1, Priti Singh1, Vidhya Verma1
1Department of Ophthalmology, All India Institute of Medical Sciences Bhopal, Bhopal, Madhya Pradesh, India.
BMJ Case Reports
|July 20, 2025
Summary
A young woman
Area of Science:
- Ophthalmology
- Hematology
- Genetics
Background:
- Central retinal vein occlusion (CRVO) typically affects older individuals with risk factors like hypertension and diabetes.
- Young patients with CRVO often lack these typical risk factors, necessitating a broader diagnostic approach.
- Recurrent symptoms and inadequate response to standard ocular therapy suggest an underlying systemic cause.
Purpose of the Study:
- To investigate the underlying cause of central retinal vein occlusion (CRVO) in a young, otherwise healthy female patient.
- To evaluate the efficacy of combined systemic and ocular therapy for managing CRVO in young patients.
- To highlight the importance of comprehensive workup for inherited thrombophilic states in unexplained CRVO.
Main Methods:
- A comprehensive diagnostic workup including infectious, autoimmune, and hematologic evaluations was performed.
- A detailed thrombophilia panel was conducted to assess for inherited prothrombotic conditions.
- Treatment involved a combination of intravitreal anti-vascular endothelial growth factor (VEGF) injections and oral anticoagulation therapy (warfarin).
Main Results:
- The patient was diagnosed with an inherited thrombophilic state, characterized by reduced free protein S activity and C4b complement levels.
- Combined therapy with anti-VEGF injections and warfarin led to stable visual acuity and resolution of macular edema.
- No recurrence of CRVO symptoms or complications was observed during a one-year follow-up period.
Conclusions:
- Comprehensive evaluation is crucial for identifying underlying inherited thrombophilic states in young patients with central retinal vein occlusion (CRVO).
- Systemic anticoagulation therapy, in conjunction with ocular treatment, can achieve successful clinical management and sustained outcomes in these cases.
- Early diagnosis and management of thrombophilia can prevent recurrent vascular events and preserve visual function.
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