Smoking and Chronic Obstructive Pulmonary Disease: Key Contributors to Central Retinal Vein Occlusion in an Elderly...

BACKGROUND Central retinal vein occlusion (CRVO) is associated with cardiovascular risk factors, but hypercoagulability, endothelial dysfunction, and stasis of blood present in patients with chronic obstructive pulmonary disease (COPD) may also play a role in its pathogenesis. This report describes the case of a 70-year-old woman who presented with reduced vision in the right eye due to CRVO. CASE REPORT A 70-year-old woman with a history of smoking presented with decreased vision in the right eye. Except for well-controlled hyperlipidemia, she lacked the classic CRVO risk factors. The workup showed elevated polyclonal free light chains (FLCs), elevated Beta-2 microglobulin (ß2M), and anemia. A thorough history-taking revealed involuntary weight loss, morning headaches, fatigue, a productive morning cough with white sputum, and shortness of breath over the past 3 months. Clinical ophthalmological examination, multimodal imaging, extensive laboratory workup, and clinical workup were performed and the results were consistent with CRVO. After pulmonary examination, spirometry, and thorax imaging, she was diagnosed with COPD. CONCLUSIONS COPD can be a potential underlying condition in patients presenting with CRVO that cannot be attributed to other etiologies, particularly if they have a past medical history suggestive of COPD. An emphasis should be placed on inquiries regarding the main symptoms of COPD: shortness of breath, morning cough, and sputum production. A further pulmonary examination may be beneficial in patients with CRVO and smoking history, given that early diagnosis of COPD prolongs survival.