First Author: B.Bandeira Rodrigues Correia PORTUGAL
Co Author(s): A. Rita Laiginhas A. Rocha L. Duarte
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To report a clinical case of branch retinal vein occlusion in a young patient, as first sign of systolic hypertension.
Hospital Central de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
We present the case of a 38-years-old women, without any known risk factors, who attend to emergency with a painless and subtle decreased visual acuity (VA) on left eye (LE) – 20/25. The right eye had a 20/20 VA and no relevant findings. On the ophthalmological exam of the LE a superior and temporal branch retinal vein occlusion (BRVO) was diagnosed with retinal haemorrhages along the branch and macular edema on the optical coherence tomography (OCT).
The patient was submitted to a complete ophthalmological and systemic workup with OCT, fluorescein angiography (FA), laboratory tests, electrocardiogram and echocardiogram to exclude any aetiology. All systemic results were normal except for a systolic hypertension found on the 24 hour blood pressure monitoring. Treatment was performed with five monthly ranibizumab intravitreal, and focal laser photocoagulation after the last injection. There was resolution of the macular edema and retinal haemorrhages with recovering of a 20/20 VA. It was prescribed for the systolic hypertension Lisinopril 10 mg once a day and regular cardiology follow-up.
Retinal occlusive disease in young patients can be the first sign of systemic disease. Thus, it requires an extensive workup to exclude potentially risk factors and underlying disease that should be directed to other medical specialities for treatment and follow up.