Combined Crvo With Crao in a Patient With Protein C Deficiency

Abstract

Retinal vascular disorders in the younger population have different underlying risk factors than in the older age group. Clinical presentation, severity, and management also depend on causative factors. Combined retinal artery and vein occlusion is very uncommon. Combined cases have mostly been attributed to rheological causes like thrombophilia, vessel wall inflammation, and mechanical compression. Protein C deficiency has mainly been linked to vein occlusions and there is no reference to protein C deficiency as a cause of combined central retinal venous obstruction and central retinal arterial obstruction. Combined cases usually present with severe visual loss and have rapid progression. Young patients having such presentation should be thoroughly evaluated to diagnose underlying factors and initiate appropriate management at the earliest.

Occlusion combinée de l’artère centrale de la rétine et de la veine centrale de la rétine révélant une maladie de Behçet

“…Des cas isolés ont été rapportés dans le cadre de certaines vasculites systémiques, de troubles rhéologiques, de pathologies tumorales, de pathologies infectieuses, de pathologies oculaires et après anesthésie rétrobulbaire [4,5].…”

Renal Papillary Necrosis Caused by Protein C Deficiency Leading to Recurrent Hydronephrosis

“…Deficiency of protein C can be quantitative (Type I) or functional (Type II) based on genetic mutations. 9,10 Immunologic assays help to differentiate between the two subtypes.…”

Combined Central Retinal Artery and Vein Occlusion Associated with Factor V Leiden Mutation and Treated with Hyperbaric Oxygen

“…This is only the 4th reported case of combined CRVO and CRAO associated with FVL mutation [ 1 , 3 ]. Due to the high frequency of severe visual impairment in this disease, the rapid onset of severe complications and the lack of an alternative therapy, an effective emergency treatment capable of reversing the visual loss is urgently needed.…”

“…Combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) is an uncommon retinal vascular disease causing sudden visual acuity loss. This is rare in young adults, and vasculitis and thromboembolic disorders are the main etiologies in these patients [ 1 ]. Factor V Leiden (FVL) mutation is a common mutation that results in a mild prohemostatic state and is a risk factor for retinal vein occlusions [ 2 ].…”

“…Factor V Leiden (FVL) mutation is a common mutation that results in a mild prohemostatic state and is a risk factor for retinal vein occlusions [ 2 ]. However, combined CRAO and CRVO in patients with FVL mutation is very rare (only 3 cases published) [ 1 , 3 ]. The prognosis of combined CRAO and CRVO is very poor, and the affected eyes typically develop severe complications, such as rubeosis iridis and neovascular glaucoma [ 4 ].…”