Farabi Eye Hospital, Retinal Services, Tehran University of Medical Sciences, Tehran, Iran.
Obstetrics and Gynecology Department, Baqyiatallah Hospital, Baqyiatallah University of Medical Sciences, Tehran, Iran.
J Med Case Rep. 2022 May 15;16(1):191. doi: 10.1186/s13256-022-03421-8.
Ocular vascular occlusion is an extremely rare event, especially in the young population. This diagnosis is always associated with active systemic diseases in young adults and needs thrombophilia workup. Nevertheless, we present the case of a pregnant woman suffering from idiopathic combined central retinal vein and cilioretinal artery occlusion.
A 36-year-old pregnant Iranian woman at the 36th week of her second pregnancy complained of subacute unilateral painless decreased vision of her left eye. She had experienced a transient vision loss that lasted several minutes, but attacks gradually became more frequent and finally persistent over a several-day period. Finally combined central retinal vein and cilioretinal artery occlusion was established. Her visual acuity improved to 4/10 in a month without any ocular intervention except for a short duration of prophylactic dose enoxaparin, and the acuity reached 8/10 without any complications in the third month follow-up visit. At 1 year follow-up, the visual acuity had not changed and no macular edema was seen.
Ocular vascular occlusion is extremely rare among young adults, and even rarer among pregnant women. According to this, any suspected retinal vascular event in this population should raise suspicion for underlying diseases such as hypertension, diabetes, autoimmune diseases, migraine, preeclampsia syndrome, and thrombophilia. However, as seen in this presented case, idiopathic ocular vascular occlusion events can occur also.
眼部血管阻塞是一种极其罕见的事件，特别是在年轻人群中。这种诊断总是与年轻成年人的活跃系统性疾病相关，并需要进行血栓形成倾向检查。然而，我们提出了一例患有特发性合并性视网膜中央静脉和睫状视网膜动脉阻塞的孕妇病例。
一名 36 岁的伊朗孕妇，处于第二次妊娠的第 36 周，抱怨左眼出现亚急性、无痛性视力下降。她曾经历过短暂的视力丧失，持续数分钟，但发作逐渐变得更加频繁，最终持续了数天。最终确诊为合并性视网膜中央静脉和睫状视网膜动脉阻塞。她的视力在一个月内提高到 4/10，除了短时间预防性使用依诺肝素钠外，没有进行任何眼部干预，并且在第三个月的随访中，视力达到了 8/10，没有任何并发症。在 1 年的随访中，视力没有变化，也没有出现黄斑水肿。
眼部血管阻塞在年轻成年人中极为罕见，在孕妇中更为罕见。根据这一点，任何在该人群中疑似视网膜血管事件都应该怀疑潜在疾病，如高血压、糖尿病、自身免疫性疾病、偏头痛、子痫前期综合征和血栓形成倾向。然而，正如本病例所示，特发性眼部血管阻塞事件也可能发生。
