This healthy 30YO male presented with sudden vision loss in his left eye. Vision was 20/20 in his healthy right eye and counting fingers in his left eye.
Optos color RG imaging shows an acute non-ischemic central retinal vein occlusion (CRVO) with mild inner retinal hemorrhages scattered in all quadrants. The optic nerve is somewhat swollen superiorly, and there is an acute cilioretinal artery occlusion in the superior papillomacular bundle.
This area is hyperreflective on OCT. Fluorescein angiography shows a well-perfused CRVO except for a localized area of ischemia within the nasal occlusion.
Learning Points:
Some patients with CRVO will develop a secondary non-embolic cilioretinal artery occlusion caused by either compression from optic nerve edema or from a sudden rise in intraluminal retinal capillary bed pressure (Hayreh et al, Retina 2008;28:581-594). Observation was recommended, and vision improved to 20/60 five days after symptom onset.
