Título / Title

BILATERAL RETINAL VENOUS OCCLUSION

Introdução / Purpose

Report the case of a patient with bilateral retinal venous occlusion with no evidence of associated thrombophilia.

Material e Método / Methods

Patient RCL, aged 65 years, male, presented with low visual acuity for one month in the left eye. Binocular indirect ophthalmoscopy showed a bilateral increase in papillary excavation, nasalization of the vessels, decrease in the arteriolar caliber and pathological arteriovenous crossings. The left eye also exhibited an increase in vessel tortuosity and engorgement, vascular sheathing, numerous surface and deep hemorrhages in the upper half of the retina, thereby compromising the macula; cotton wool spots, lipid microexudates and retinal edema, characterizing hypertensive retinopathy in both eyes and upper hemispheric occlusion of the central retinal vein in the left eye. Intravitreal antiangiogenic administration and laser photocoagulation was performed in the left eye after greater hemorrhage absorption. After five months, his visual acuity was 20/400 in the right eye and 20/40 in the left eye. Ophthalmoscopy exhibited central retinal vein occlusion in the left eye with surface and deep hemorrhages, except in the upper nasal region. Intraocular pressure was 22/26 mmHg. Topical ocular hypotensive and intravitreal antiangiogenic drugs were used and laser photocoagulation was applied to the left eye. Intraocular pressure in the left eye rose to 50 mmHg, and oral acetazolamide was added to ocular hypotensive therapy. Intraocular pressure (IOP) was normalized and he is currently taking only topical medication.

Resultados / Results

The causes of thrombophilia were investigated, but since all marker levels were normal, including homocysteine, venous occlusions were attributed primarily to hypertension.

Discussão e Conclusões / Conclusion

It is important to investigate the cause of thrombophilia in patients affected by retinal vascular occlusions, mainly bilateral cases. However, in the vast majority, laboratory tests were completely normal, revealing the base pathology as the inducer of these occlusions.

Palavras Chave

occlusion; venous; retinopathy.

Area

CLINICAL RETINA