Central Retinal Vein Occlusion Associated With Progestin-Only Contraceptive Implant Use

Purpose: The purpose of the study is to present a case of central retinal vein occlusion (CRVO) associated with the use of progestin-only contraceptive implant. Methods: The study is a case report. Results: This is a case of a 34-year-old Caucasian female nonsmoker who presented with sudden-onset painless blurring of vision of the left eye. There were no associated ocular and systemic signs or symptoms. She has no comorbidities. The patient disclosed that she was on the etonogestrel implant, a progestin-only contraceptive, at the time of consult. She was previously diagnosed with a CRVO of the right eye while on the combined hormonal contraceptive in 2017. She had a best corrected visual acuity (BCVA) of 6/6 in both eyes. Anterior segment examinations of both eyes were unremarkable. Fundus examination of the right eye revealed normal findings; however, the fundus exam of the left eye showed a clear media with a healthy looking disc but with sparse dot blot hemorrhages in all retinal quadrants and dilated and tortuous retinal vessels, along with a healthy-looking macula. Macular optical coherence tomography (OCT) did not show any signs of macular edema. Carotid ultrasound, autoimmune, and coagulation panels were all normal. Subsequent visits showed complete resolution of the retinal hemorrhages, and the retinal vasculature returned to normal anatomical configuration. A diagnosis of left CRVO secondary to etonogestrel implant was made. Conclusion: This study recognized that the use of progestin-only contraceptives still has an increased risk of thrombosis. It is essential to consider the mode of administration and duration of use of these contraceptives.