Purpose: Central retinal vein occlusion (CRVO) and rhegmatogenous retinal detachment (RRD) are two distinct retinal conditions that typically affect older patient populations with comorbidities or predisposing risk factors. This case report presents unusual co-occurrences of CRVO and RRD in two young, healthy adult patients and proposes potential etiological factors contributing to the complex presentations.
Methods: This was a retrospective case series of two young, healthy male patients with no history of systemic diseases who presented with concurrent CRVO and RRD.
Results: The first case was a 28-year-old male construction worker, who presented with acute, painless vision loss and extensive intraretinal hemorrhages in the right eye, tortuous dilated retinal veins, significant macular edema, optic disk edema, and a macula-sparing RRD. Treatment included intravitreal injections of bevacizumab followed by RRD repair with scleral buckle, cryotherapy, external drainage, and later a pneumatic retinopexy. His visual acuity had improved from 20/200 to 20/30 in the right eye. The second case was a 19-year-old male patient who also presented with acute painless vision loss in the left eye and was diagnosed with CRVO and concomitant retinal detachment. Treatment included intravitreal bevacizumab injections, oral prednisone trial, and surgical repair with scleral buckle, vitrectomy, and silicone oil insertion. Workup for inflammatory, infectious, and hypercoagulable conditions was negative in both cases.
Conclusion: Concurrent CRVO and RRD can occur in young healthy patients. Prompt surgery is indicated, and treatment with antivascular endothelial growth factor can be initiated in the perioperative period without complications.
Keywords: central retinal vein occlusion; healthy adult; rhegmatogenous retinal detachment.