Author: Amina Abounaceur (Morocco)
Co-authors: Jihane Ait elhaj, Kenza Hamraoui, Adil Mchachi, Laila Benhmidoune, Rayad Rachid, Mohamed El Belhadji
Purpose
Retinal venous occlusion (RVO) is a common pathology, in particular in the elderly with cardiovascular risk factors; it represents the most common retinal vascular disease after diabetic retinopathy. Its course depends on its clinical form; it may be an ischemic or non-ischemic form from the start, which may progress less favorably either to an ischemic form, or in some cases favorably to spontaneous permeabilization. We report the case of spontaneous recanalization of an occlusion of the central retinal vein.
Setting/Venue
Adult Ophthalmology Department, Hospital August 20, 1953, CHU Ibn Rochd.
Methods
This is a 41-year-old patient with no particular pathological history, in particular no cardiovascular risk factors or glaucoma, who consulted for a sudden drop in unilateral visual acuity of the left eye , dating back to a week before consultation, without eye redness or pain.
Results
On ophthalmologic examination of the OG, the visual acuity showed a positive light perception. Examination of the appendages and the anterior segment was unremarkable. Slit lamp examination showed a diminished and consensual direct pupillary reflex retained, eye tone at 12 mmhg. Fundus examination revealed diffuse venous tortuosity, stage III papillary edema, flaming hemorrhages and cottony nodules. The ophthalmologic examination of the right eye was normal. An emergency retinal fluorescein angiogram was done, which showed the appearance of central retinal vein occlusion in its non-ischemic form. The macular OCT of the OG did not objectify macular edema. An emergency cardiovascular examination associated with a cardiac ultrasound and a supraortic trunks doppler ultrasound did not show any abnormality. After two months of monitoring, the evolution was marked by an improvement of the VA, which passed to 9/10 in the temporal field and to counts the fingers at two meters in the nasal field, and an aspect of a recanalization of OF venous vascularization, confirmed by control retinal angiography.
Conlusions
Retinal venous occlusions most often occur in subjects over 50 years of age presenting one or more cardiovascular risk factors (hypertension, hypercholesterolemia, diabetes, smoking). Their occurrence may be favored by ocular hypertonia. Its clinical diagnosis is straightforward, due to a typical clinical picture in fundus. The fundus examination and fluorescein angiography make it possible to identify two clinical forms: well perfused form, called non-ischemic form, and ischemic form. Spontaneous progression to vascular recanalization without having a complication (ischemia or macular edema) remains an exceptional situation.
Financial Disclosure
there is no specific companies which we have financial relations
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