This work illustrates the case of cilioretinal artery occlusion (CilRAO) combined with central retinal vein occlusion (CRVO) in a young patient that resolved spontaneously. A 17-year-old male with an unremarkable medical history presented with acute painless loss of vision unilaterally. Upon ophthalmologic examination, retinal hemorrhages in all four quadrants and edema extending from the optic disc to the macula were reported. Using optical coherence technology (OCT) imaging and fundus fluorescein angiography (FFA), combined CilRAO/CRVO was diagnosed. The full medical evaluation was unremarkable. Within the next month, the patient had regained full visual acuity (VA) in the affected eye, and the retinal findings resolved without intervention. Combined CilRAO/CRVO is a common vascular pathology in young, otherwise healthy patients. It is commonly considered a hemodynamic block in the capillary bed, hence its hopeful prognosis. Nonetheless, several risk factors have been proposed that need to be eliminated. Despite the initial alarming symptoms, young patients with CilRAO/CRVO should be monitored closely, and intervention should be resorted to when necessary.

We aim to present a unique case of unilateral paracentral acute middle maculopathy (PAMM) associated with cilioretinal artery insufficiency following the coronavirus disease 2019 (COVID-19) vaccination. A 28year-old male complained of a sudden blurring of vision in his left eye 40 days after receiving the second dose of COVID-19 immunization. The optical coherence tomography revealed a diffuse paracentral area of hyper-reflective change in the inner plexiform layer and an increase in the inner nuclear layer volume, consistent with PAMM along the course of the cilioretinal artery. PAMM has been connected to an assortment of retinal vasculature anomalies. Considering COVID-19 vaccination, we hypothesize that the immunogenic cascade following vaccination dysregulated coagulation and led to retinal vascular thrombosis. However, the link between COVID-19 vaccination and retinal vascular occlusion disease remains unknown.