Combined Central Retinal Vein and Cilioretinal Artery Occlusion in the Setting of Intravenous Immunoglobulin Administration

2021 ◽  
pp. 247412642199860
Author(s):  
Jonathan Cin-Bon Tsui ◽  
Gordon Scott Crabtree
Keyword(s):  
Intravenous Immunoglobulin ◽  
Vascular Occlusion ◽  
Artery Occlusion ◽  
Necrotizing Autoimmune Myopathy ◽  
Cilioretinal Artery Occlusion ◽  
Cilioretinal Artery ◽  
Optical Coherence Tomography Imaging ◽  
Autoimmune Myopathy ◽  
Central Retinal Vein ◽  
Ivig Administration

Purpose: This work reports a case of combined vascular occlusion in the setting of intravenous immunoglobulin (IVIg) administration. Methods: The authors describe a case of combined central retinal vein and cilioretinal artery that occurred in the setting of IVIg administration. Results: A 52-year-old White man presented with a unilateral subjective scotoma that began during IVIg administered for the treatment of statin-induced necrotizing autoimmune myopathy. Examination and optical coherence tomography imaging revealed a combined nonischemic central retinal vein and cilioretinal artery occlusion. Conclusions: To the authors’ review and knowledge, this is the first reported case of combined central retinal vein and cilioretinal artery occlusion occurring in the setting of IVIg administration. This rare adverse effect is an entity to be considered in patients who are treated with IVIg.

Cilioretinal Artery Occlusion in Young Adults with Central Retinal Vein Occlusion

Ophthalmology ◽  
1991 ◽  
Vol 98 (5) ◽  
pp. 594-601 ◽  
Author(s):  
Howard Schatz ◽  
Andrew C.O. Fong ◽  
H. Richard McDonald ◽  
Robert N. Johnson ◽  
Leonard Joffe ◽  
...  
Keyword(s):  
Young Adults ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Artery Occlusion ◽  
Vein Occlusion ◽  
Cilioretinal Artery Occlusion ◽  
Cilioretinal Artery ◽  
Central Retinal Vein

scholarly journals An Unusual Case of Concurrent Central Retinal Vein and Cilioretinal Artery Occlusion in a Healthy Patient

2021 ◽  
pp. 407-411
Author(s):  
Eunice Jin Hui Goh ◽  
Kong Yong Goh
Keyword(s):  
Methylenetetrahydrofolate Reductase ◽  
Arterial Occlusion ◽  
Artery Occlusion ◽  
Vein Occlusion ◽  
Cilioretinal Artery Occlusion ◽  
Life Threatening ◽  
History Of ◽  
Cilioretinal Artery ◽  
Vascular Occlusions ◽  
Central Retinal Vein

It is rare for young, healthy patients to have retinal venous or arterial occlusions and even rarer for both to occur in concert. Such an occurrence should prompt a rapid and extensive workup to prevent further complications. We present our patient, a 37-year-old Lebanese male, who reported a 3-day history of blurring of vision in his left eye. He had no medical or ocular history and is a nonsmoker. Examination of the left fundus revealed inferior macular edema and retinal whitening associated with tortuous retinal veins. He was diagnosed with a combined central retinal vein and cilioretinal artery occlusion. Emergency treatment was done for an acute arterial occlusion. Embolic and thrombotic causes were excluded with investigations. The only positive result was homozygosity for 677C>T mutation of the 5,10 methylenetetrahydrofolate reductase (MTHFR) enzyme gene. MTHFR enzyme breaks down homocysteine, which is atherogenic and prothrombotic. This mutation can lead to a prothrombotic state, precipitating this occurrence. In fact, the Lebanese population is known to have the highest incidence of such mutations, but there are surprisingly few reports on retinal vascular occlusions attributed to this. He was promptly treated with antiplatelet therapy, possibly preventing a full-blown central retinal vein occlusion. After 4 weeks, his vision improved to 6/6 bilaterally. Examination showed less tortuous veins, no more retinal whitening, resolution of macula edema and visual field defect. Hyperhomocysteinemia can be significant in patients without ischemic risk factors. It is vital to manage these patients promptly, preventing future sight and life-threatening events.

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