Título / Title

BILATERAL RETINAL VENOUS OCLUSION

Introdução / Purpose

To report the case of a patient with bilateral retinal venous occlusion without evidence of associated thrombophilia.

Material e Método / Methods

Patient RCL, 65 years old, male, presenting with visual acuity loss in the left eye 1 month. Presented, bilaterally, increased papillary excavation, vascular anasalation, arteriolar caliber reduction, and pathological arteriovenous crosses. In the left eye there was also an increase in tortuosity and venous engorgement, vascular sheathing, numerous superficial and deep haemorrhages in the upper half of the retina, including the macula; white cotton spots, lipid microexudates and retinal edema, characterizing hypertensive retinopathy in both eyes and superior hemispheric occlusion of the central retinal vein in the left eye. An intravitreal antiangiogenic and laser photocoagulation administration was performed in the left eye. Five months later, his visual acuity was 20/400 in the right eye and 20/40 in the left eye. Presented occlusion of the central retinal vein in the right eye with superficial and deep hemorrhages, sparing only part of the upper nasal region. In the left eye there was great absorption of hemorrhages, with extensive area of superior capillary nonperfusion, vascular collaterization and disc neovascularization. Topical ocular hypotensive medication, intravitreal antiangiogenic and laser photocoagulation were performed in the left eye. There was normalization of IOP and currently only uses topical medication.

Resultados / Results

Causes of thrombophilia were investigated, but all dosages were normal, including homocysteine, and venous occlusions were attributed to the essentially hypertensive condition.

Discussão e Conclusões / Conclusion

It is fundamental to investigate the cause of thrombophilia in patients with retinal vascular occlusions, especially in cases with bilateral involvement. However, in the vast majority of cases, the laboratory investigation is completely normal, denouncing the underlying pathology as inducer of such occlusions.

Palavras Chave

OCLUSION - VENOUS - RETINAL - BILATERAL