Título / Title

CENTRAL VEIN OCCLUSION DUE TO DEHYDRATION AFTER INTENSE SPORT ACTIVITY IN A YOUNG INDIVIDUAL

Introdução / Purpose

To report a case of a male young athlete which presented with central vein occlusion (CRVO).

Material e Método / Methods

Case report.

Resultados / Results

37-years-old white athlete male presented complaining of painless and severe vision loss on OS for 15 days, after running a long distance without proper hydration. Medical and family history were unremarkable. The BCVA was 20/20 on OD and counting fingers 4 inches on OS. Biomicroscopy of the anterior segment was unremarkable. Fundus examination of the OS showed swollen disc, numerous intraretinal hemorrhages and cotton-wool spots, macular edema (ME) and tortuous and dilatated retinal vasculature in the 4 quadrants (Figures 1, 2). The fluorescein angiography showed arterial filling delay (Figure 3) hyper and blocked fluorescence in affected areas. OCT reveled 1290 µm macular edema with increased reflectivity of the inner layers of the retina (Figure 4). Lab tests revealed elevated erythrocyte sedimentation rate (29mm), cholesterol (250mg/dL) and cholesterol LDL (163mg/dL). The patient was then diagnosed with CRVO with an arterial component and was scheduled to receive 3 intra-vitreous injections of anti-VEGF. After 14 days of the first injection the fundus appearance and macular edema improved (Figures 5, 6). After 60 days of the third injection BCVA was 20/200. His optic nerve disc was pale and the macula had residual exudates with foveal sparing small cysts (Figures 7, 8). 4 months after, the BCVA was 20/100, retinal neovascularization could be observed in the posterior pole and the OCT showed no macular edema.

Discussão e Conclusões / Conclusion

CRVO is usually a disorder which affects patients over 60 years old and is rarely reported in young healthy patients and dehydration could be involved in the mechanism which is likely to be in this case due to the intense exercise without proper hydric reposition. In healthy under 40-year individuals, an extensive workup is needed, which is negative in most of these patients.

Palavras Chave

Retinal Vein Occlusion; Retinal Artery Occlusion; Retinal Neovascularization.