Central Retinal Vein Occlusion in Younger Swedish Adults: Case Reports and Review of the Literature

Abstract

Purpose:To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature.Methods:Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors.Results:Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (µm) at the initial examination to 243.8±48.1 (µm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (µm) in the ischemic CRVO group, which decreased to 211.5±20.2 (µm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described.Conclusion:The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.

Central retinal vein occlusion in a young healthy COVID-19 patient: A case report

“…The occurrence of CRVO in adults under 60 years of age has been reported to be considerably less common than in older patients. Systemic hypertension was found to be the most prevalent risk factor for CRVO in young patients, followed by diabetes mellitus and hyperlipidemia, 17 all of the above were not found in our patient.…”

An Ophthalmic Changes in Patients with Chronic Obstructive Pulmonary Disease: Case-Control Study

“…This study is relevant given the evidence that ophthalmological manifestations in COPD patients are infrequently recognized and therefore are not part of the follow-up protocol for these patients [16][17][18][19][20][21]24]. The current research findings support the referral to the ophthalmologist of COPD patients followed in the routine of pulmonology.…”

“…Among the most wellknown manifestations are heart diseases and pulmonary vascular diseases, as well as malnutrition with dysfunction of the skeletal muscles, osteoporosis, anemia, among others [14,15]. In this context, ocular complications are understood as unrecognized manifestations, although they may be potentially serious and, in many cases, irreversible if not recognized in a timely manner, such as hypertensive retinopathy, retinal hemorrhage, glaucoma, age-related macular degeneration, endothelial vulnerability to cataract surgery, changes in the nerve fiber layer, among others [16][17][18][19][20][21]. Hence, the importance of such disorders being investigated during the followup of these patients in clinical practice, alerting health professionals about their existence and severity, since the knowledge about systemic diseases evolving with ocular complications [22,23] is scarce among the professionals of the eye health area.…”

Clinical Features of Central Retinal Vein Occlusion in Young Patients

“…CRVO causes varying degrees of visual impairment. Currently, the literature defines CRVO cases in patients \ 50 years old as CRVO in the young [1][2][3][4][5][6]. However, some studies have defined CRVO in the young as that occurring in patients either \ 40 [7] or \ 55 [8] years old.…”