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[Bilateral central retinal vein occlusion and circulating anticoagulant]
M A Lureau1, A Glacet-Bernard, G Coscas
1Clinique Ophtalmologique Universitaire Paris-XII, Créteil.
Journal Francais D'Ophtalmologie
|January 1, 1995
Summary
This case report details a patient who experienced central retinal vein occlusion in both eyes. Unusual risk factors identified included lupus anticoagulant antibodies and rheological abnormalities, highlighting potential contributors to retinal vascular occlusion.
Area of Science:
- Ophthalmology
- Vascular Medicine
Background:
- Central retinal vein occlusion (CRVO) is a significant cause of vision loss.
- Risk factors for CRVO typically include hypertension, diabetes, and hyperlipidemia.
- Bilateral CRVO is uncommon, necessitating investigation into underlying systemic and ocular factors.
Observation:
- A 68-year-old male presented with bilateral central retinal vein occlusion.
- Initial presentation in the first eye was non-ischemic CRVO, progressing to ischemic CRVO requiring laser panretinal photocoagulation.
- The patient had a history of thyroid disorder, cardiac arrhythmia, and bilateral tilted discs.
Findings:
- Biological assays revealed lupus anticoagulant antibodies and significant rheological abnormalities, including major plasma hyperviscosity, increased erythrocyte aggregation, high hematocrit, and fibrinogen levels.
- CRVO recurred in the fellow eye one year after initial treatment, shortly after a reduction in troxerutin dosage.
- Despite recurrence, visual acuity remained unchanged after hemodilution therapy.
Implications:
- This case highlights unusual risk factors for CRVO, specifically lupus anticoagulant antibodies and abnormal rheological findings.
- Tilted discs may play a role in the pathogenesis of CRVO.
- The findings suggest that lupus anticoagulant antibodies and rheological abnormalities can be contributory factors in the development of retinal vascular occlusion, even if not commonly found.