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Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man
An otherwise healthy 24-year-old man presented with a painless decrease of vision in the left eye for 2 days. Best-corrected visual acuity was 20/20 in the right eye and 20/80 in the left eye. Anterior exam was unremarkable and funduscopic exam in the left eye revealed retinal hemorrhages in all fou...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445948/ https://www.ncbi.nlm.nih.gov/pubmed/26056427 http://dx.doi.org/10.2147/OPTH.S84214 |
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author | Kavoussi, Shaheen C Kempton, James E Huang, John J |
author_facet | Kavoussi, Shaheen C Kempton, James E Huang, John J |
author_sort | Kavoussi, Shaheen C |
collection | PubMed |
description | An otherwise healthy 24-year-old man presented with a painless decrease of vision in the left eye for 2 days. Best-corrected visual acuity was 20/20 in the right eye and 20/80 in the left eye. Anterior exam was unremarkable and funduscopic exam in the left eye revealed retinal hemorrhages in all four quadrants with venous dilation and tortuosity consistent with central retinal vein occlusion. Fluorescein angiography revealed delayed venous filling with neither leakage nor vasculitis. A comprehensive work-up that included infectious, inflammatory, and hypercoagulability studies was unremarkable, and magnetic resonance imaging of the orbits was unrevealing. After 2 months, best-corrected visual acuity returned to 20/20-2 in the left eye. Upon closer review of the vascular anatomy in the left eye, a bifurcation of the central retinal artery at the level of the optic disc was tightly intertwined with an undilated nasal retinal vein in a manner that appeared to compress the underlying central retinal vein, resulting in dilation and tortuosity of the remaining venous branches. The vessel wall damage, turbulent venous flow, and compressive mass effect resulting from the anomalous retinal vasculature relationship is the proposed mechanism of the central retinal vein occlusion. Careful attention to the retinal vascular anatomy is suggested to aid in assessing the risk of retinal vein occlusion in any age group. |
format | Online Article Text |
id | pubmed-4445948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-44459482015-06-08 Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man Kavoussi, Shaheen C Kempton, James E Huang, John J Clin Ophthalmol Case Report An otherwise healthy 24-year-old man presented with a painless decrease of vision in the left eye for 2 days. Best-corrected visual acuity was 20/20 in the right eye and 20/80 in the left eye. Anterior exam was unremarkable and funduscopic exam in the left eye revealed retinal hemorrhages in all four quadrants with venous dilation and tortuosity consistent with central retinal vein occlusion. Fluorescein angiography revealed delayed venous filling with neither leakage nor vasculitis. A comprehensive work-up that included infectious, inflammatory, and hypercoagulability studies was unremarkable, and magnetic resonance imaging of the orbits was unrevealing. After 2 months, best-corrected visual acuity returned to 20/20-2 in the left eye. Upon closer review of the vascular anatomy in the left eye, a bifurcation of the central retinal artery at the level of the optic disc was tightly intertwined with an undilated nasal retinal vein in a manner that appeared to compress the underlying central retinal vein, resulting in dilation and tortuosity of the remaining venous branches. The vessel wall damage, turbulent venous flow, and compressive mass effect resulting from the anomalous retinal vasculature relationship is the proposed mechanism of the central retinal vein occlusion. Careful attention to the retinal vascular anatomy is suggested to aid in assessing the risk of retinal vein occlusion in any age group. Dove Medical Press 2015-05-20 /pmc/articles/PMC4445948/ /pubmed/26056427 http://dx.doi.org/10.2147/OPTH.S84214 Text en © 2015 Kavoussi et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Case Report Kavoussi, Shaheen C Kempton, James E Huang, John J Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title | Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title_full | Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title_fullStr | Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title_full_unstemmed | Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title_short | Central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
title_sort | central retinal vein occlusion resulting from anomalous retinal vascular anatomy in a 24-year-old man |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445948/ https://www.ncbi.nlm.nih.gov/pubmed/26056427 http://dx.doi.org/10.2147/OPTH.S84214 |
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