Central Retinal Artery Occlusion Following Central Retinal Vein Occlusion- A Case Report

A 73-year-old gentleman with diabetes mellitus was found to have impending central retinal vein occlusion (CRVO), on routine eye check-up. Despite initiation of anti-platelet agent, he developed ischaemic CRVO two months later, with severe macula oedema. His systemic investigations showed good diabetic control, no blood dyscrasia/ hypercoagulable state, normal lipid profile and inflammatory markers. Echocardiogram was normal. A month later, arteriolar attenuation was noted with rubeosis irides, and fluorescein angiogram study confirmed central retinal artery occlusion (CRAO). After ruling out the systemic risk factors, we postulate two possible anatomical related patho-mechanism of CRAO following CRVO: 1, CRVO converts the retinal circulation into a closed loop, results in complete hemodynamic block of the retinal circulation, and hence secondary CRAO; 2, swollen retinal nerve fibres at the optic nerve head secondary to CRVO cause compression to the retinal artery at the level of the lamina cribrosa, this compression is further aggravated by the increased in intraocular pressure (IOP), and hence secondary CRAO. Central Retinal Artery Occlusion Following Central Retinal Vein OcclusionA Case Report Umi Kalthum Md Noh*, Sin Yee Fang and Norshamsiah Md Din Department of Ophthalmology, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia *Corresponding author: Umi Kalthum Md Noh, Department of Ophthalmology, Pusat Perubatan Universiti Kebangsaan Malyaysia, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia, Tel: 0060177594052; E-mail: [email protected] Received May 28, 2015; Accepted June 19, 2015; Published June 23, 2015 Citation: Md Noh UK, Fang SY, Md Din N (2015) Central Retinal Artery Occlusion Following Central Retinal Vein OcclusionA Case Report. J Diabetes Metab 6: 566. doi:10.4172/2155-6156.1000566 Copyright: © 2015 Md Noh UK, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.