Central Retinal Vein Occlusion Associated With Progestin-Only Contraceptive Implant Use
Jan Patrick O Chu1, David I T Sia1,2,3
1Department of Ophthalmology, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia.
Case Reports in Ophthalmological Medicine
|July 22, 2025
Summary
Progestin-only contraceptives, like the etonogestrel implant, may increase the risk of central retinal vein occlusion (CRVO). This case report highlights the importance of considering contraceptive use in patients presenting with CRVO.
Area of Science:
- Ophthalmology
- Vascular Medicine
- Reproductive Health
Background:
- Central retinal vein occlusion (CRVO) is a serious vascular condition affecting vision.
- Progestin-only contraceptives are widely used for family planning.
- Previous associations between combined hormonal contraceptives and venous thromboembolism exist.
Observation:
- A 34-year-old woman presented with sudden, painless vision loss in her left eye.
- She was using an etonogestrel implant (progestin-only contraceptive).
- She had a history of CRVO in the right eye while on combined hormonal contraceptives.
Findings:
- Fundus examination revealed retinal hemorrhages and dilated, tortuous vessels in the affected eye.
- Optical coherence tomography excluded macular edema.
- Systemic workup, including coagulation and autoimmune panels, was normal.
- Diagnosis of left CRVO secondary to etonogestrel implant was established.
- Complete resolution of hemorrhages occurred after diagnosis.
Implications:
- This case suggests a potential link between progestin-only contraceptives and CRVO.
- Healthcare providers should consider contraceptive history in patients with CRVO.
- Further research is needed to clarify the thrombotic risk associated with progestin-only contraceptives, considering administration and duration of use.
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