Severe occlusive retinal periphlebitis with vitreous hemorrhage in multiple sclerosis

Severe ocular complications in multiple sclerosis are rare. A 43-year-old patient had a history of diplopia episodes and optic neuritis in the right eye between 1979 and 1980. In 1984, multiple sclerosis had been diagnosed. The patient presented with visual deterioration in the right eye in 1992. Ophthalmoscopy and fluorescein angiography showed severe occlusive retinal periphlebitis with diffuse retinal hemorrhages and large areas of nonperfusion. At the time of presentation the patient was in general good health and presented no neurological sign. Examinations for other causes of periphlebitis were negative. Although treatment with laser therapy and corticosteroids was initiated, the patient developed recurrent vitreous hemorrhages that required pars plana vitrectomy. In 1993 the patient suffered from a general deterioration of the disease course and was treated with systemic immunosuppressive medication. Vitreous hemorrhage is a rare complication of multiple sclerosis.