Central Retinal Vein Occlusion with a Branch Sparing: A Case Report

Purpose: To report a case of central retinal vein occlusion (CRVO) with a branch sparing in a patient without particular coagulopathies. Methods: retinal vein occlusion (RVO) is a sight-threatening retinal vascular disorder with prevalence of 0.7-1.6%. Main risk factors for the disease are age, hypertension, hyperlipidemia, diabetes mellitus, ocular hypertension and thrombophilic disorders. CRVO has two types including ischemic or non-ischemic according to clinical and para clinical investigations. We present an unusual case of non-ischemic CRVO in a 57 years old female with diabetes mellitus and hypertension as systemic diseases. All main branches of retinal vein except inferotemporal were occluded with macular edema in the right eye of the patient. Signs of the disease were confirmed by multimodal imaging s including optical coherence tomography and fluorescein angiography. In further investigation she did not have any particular cardiovascular diseases or specific thrombophilic disorders containing hyperhomocysteinemia, anti-cardiolipin antibodies, factor V Leiden mutation and protein C and S deficiency. We did not found any similar reports of multiple branches RVO.Results: Due to macular edema that leads to decreased visual acuity, intravitreal bevacizumab injection was performed in the affected eye. After one-month follow-up visit, the signs of RVO were regressed and macula edema was resolved in optical coherence tomography, so the patient underwent observation with follow-up visits. Conclusion: Patients presenting with multiple branches RVO should be investigated carefully to rule out any underlying thrombophilic disorders to prevent any further vaso-occlusive event and subsequently morbidities and mortality.