Systemic considerations in bilateral central retinal vein occlusion

BackgroundCentral retinal vein occlusion (CRVO) is a common cause of visual impairment and can occur at any age. Nonetheless, 90% of patients with CRVO are older than 50 years, and only 10% of CRVO patients are younger than 40 years. Systemic vascular diseases, such as hypertension and diabetes, are common risk factors for the development of CRVO. However, when a patient less than 50 years of age has bilateral and simultaneous central retinal vein occlusions, a hyperviscosity syndrome or inflammatory condition is also suspected.Case reportThis article presents the case of a 40-year-old man with bilateral ischemic CRVO and the differential diagnoses considered, including systemic lupus erythematosus (SLE), antiphospholipid antibody syndrome (APAS), dysproteinemias, and hyperhomocysteinemia.ConclusionWhen a CRVO is observed in a young patient, more obscure underlying etiologies must be explored. As primary care providers, optometrists need to consider common (and atypical) vascular risk factors for vein occlusion to prevent further ocular morbidity and systemic complications.