Combined occlusion of the central retinal artery and vein

A 56-year-old man, complaining of sudden visual loss in his left eye, demonstrated cream-colored retinal edema along a macular branch of the central retinal artery, overall delay of fluorescence in angiography and general depression of the central visual field, which were interpreted as the incomplete form of central retinal artery occlusion (CRAO) mimicking cilioretinal or branch retinal artery occlusion. After receiving paracentesis and fibrinolytic agents, the patient recovered his vision gradually, while the ophthalmoscopic findings progressed to show central retinal vein occlusion (CRVO) changes consisting of dilated and tortuous retinal veins and scattered intraretinal hemorrhages. The condition associated with the retinal edema indicated combined obstruction of the central retinal artery and the central retinal vein (combined CRAO/CRVO). Six months later, both the ocular fundus and the vision returned to normal. The similar cases in Japanese literature in which ophthalmoscopic findings of combined CRAO/CRVO was followed by aggravation of CRVO changes with or without recovery of vision were reviewed.