J Korean Ophthalmol Soc.  2020 Nov;61(11):1380-1385. 10.3341/jkos.2020.61.11.1380.

Bilateral Central Retinal Vein Occlusion in a Patient with Takayasu Arteritis

Affiliations
  • 1Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 2Research Institute for Convergence of Biomedical Science and Technology, Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 3Biomedical Research Institute, Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
  • 4Biomedical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea

Abstract

Purpose
We report bilateral central retinal vein occlusion in a patient with Takayasu arteritis.
Case summary
A 52-year-old female with hypertension complained of decreased vision in both eyes. The best-corrected visual acuities (BCVAs) were 0.2 in the right eye and 0.15 in the left eye. Fundus examination and optical coherence tomography revealed dilated and tortuous retinal veins, many flame-shaped hemorrhages, and macular edema in both eyes. We diagnosed central retinal vein occlusion in both eyes. Neck ultrasonography and computed tomography/angiography revealed Takayasu arteritis with near-total occlusion of the left common carotid artery, external carotid artery, and subclavian artery. We prescribed oral azathioprine and three monthly intravitreal injections of bevacizumab (Avastin®; Genentech, Inc., South San Francisco, CA, USA, 1.25 mg/0.05 mL). After 6 months of treatment, the retinal hemorrhage and macular edema disappeared and the BCVAs improved to 0.6 in the right and 0.8 in the left eye.
Conclusions
When encountering a case of bilateral central retinal vein occlusion, assessment of systemic vascular occlusive diseases such as Takayasu arteritis may be required.

Keyword

Bilateral central retinal vein occlusion; Takayasu arteritis
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