Simultaneous Branch Retinal Artery and Central Retinal Vein Occlusions following Blood Transfusion in a Young Man: A...

Simultaneous branch retinal artery occlusion (BRAO) and central retinal vein occlusion (CRVO) is an exceptionally rare cause of acute vision loss, particularly in young individuals without systemic vascular risk factors. Blood transfusion has been implicated in rare thromboembolic and hyperviscosity-related complications but is infrequently associated with retinal vascular occlusions.

A 20-year-old man presented with sudden painless unilateral vision loss shortly after receiving a packed red blood cell transfusion for severe anemia. Ophthalmic examination revealed optic disc edema, venous engorgement, scattered retinal hemorrhages, and superior hemi-macular whitening in the affected eye. Structural optical coherence tomography demonstrated inner retinal hyperreflectivity and subsequent thinning, consistent with ischemic retinal injury. Fluorescein angiography was contraindicated due to an acute hypersensitivity reaction. Extensive systemic, hematologic, inflammatory, and thrombophilia workup was unremarkable. Despite conservative and supportive management, including hyperbaric oxygen therapy and anticoagulation, visual recovery remained limited at follow-up.

This case highlights a rare presentation of concurrent BRAO and CRVO occurring shortly after blood transfusion in a young patient without identifiable systemic risk factors. Although causality cannot be definitively established, the close temporal relationship and exclusion of alternative etiologies suggest transfusion-related rheologic changes as a plausible contributing factor. Clinicians should remain vigilant for acute retinal vascular events following transfusion, even in young patients, and prompt ophthalmic evaluation is essential.