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Central retinal artery occlusion in a child with T-cell lymphoma
R G Cohen1, T R Hedges, J S Duker
1New England Eye Center, New England Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Insights
Central retinal artery occlusion in children is rare. Prompt treatment with paracentesis and anticoagulation improved vision, and T-cell lymphoma was later diagnosed.
Area of Science:
- Ophthalmology
- Pediatrics
- Hematology
Background:
- Central retinal artery occlusion (CRAO) is uncommon in pediatric patients.
- Identifying the underlying cause of CRAO in children is crucial for effective management.
Observation:
- A pediatric patient presented with CRAO.
- Initial treatment involved paracentesis and anticoagulation, leading to visual improvement.
Findings:
- Systemic T-cell lymphoma was subsequently diagnosed as the underlying cause.
- Unlike adults where atherosclerosis is common, children often have less obvious systemic or ocular associations.
Implications:
- Lymphoma should be considered in the differential diagnosis of pediatric CRAO.
- Early diagnosis and treatment of associated systemic conditions are vital for visual outcomes in pediatric CRAO.
Purpose/Methods:
Central retinal artery occlusion occurs infrequently in children. We treated a child with central retinal artery occlusion before a systemic disease was discovered.
Results/Conclusion:
Vision improved after paracentesis and anticoagulation. Systemic T-cell lymphoma was subsequently diagnosed. In contrast to older patients in whom atheromatous disease is a common etiologic factor, children frequently have more obscure systemic or ocular associations. Lymphoma should be considered as a possible systemic association in cases of central retinal artery occlusion, especially in younger patients who are less at risk for the more common causes.