Posters

Central retinal artery occlusion: surprise etiology

Poster Details

First Author: N.Nastase ROMANIA

Co Author(s): A. Amariei   I. Bujor   R. Iancu   O. Ameyoud   R. Pirvulescu        

Abstract Details

Purpose:

To investigate a young pacient with central artery occlusion in order to find the etiology.

Setting:

A 28 years old male was admitted to our clinic due to sudden, painless decreased visual acuity of left eye for about 2 weeks. The patient was diagnosed with central retinal artery occlusion (CRAO) of the left eye with cilioretinal artery sparing and he was further investigated.

Methods:

Visual acuity of the left eye (LE) was 1/15 sc. from temporal side, Goldmann visual field of LE revealed a temporal island with white and colour desaturation and LE fundus examination showed a blurred optic disc with whitish retinal oedema keeping a perfused inferotemporal area. Transcranial Doppler ultrasound showed a decreased velocity flow in the left carotid artery. Cerebral angiography revealed a dissection at the left internal carotid artery level with significant hemodynamic stenosis and also dissections in both vertebral arteries.

Results:

The pacient presented multiple non-traumatic arteries dissections, personal history highlighted repeated ecchymosis with incomplete long-term resolution and clinical examination revealed a very tight, elastic and translucent skin. All of these signs rised the suspicion of vascular Ehlers-Danlos Syndrome (type IV). Therefore skin was prelevated for biopsy which indicated changes in elastic fibers. To confirm vascular Ehlers-Danlos Syndrome specific genetic tests was performed which showed the presence of a mutation in the COL3A1.

Conclusions:

The central retinal artery occlusion in young patients is an uncommon diagnose. The patients must be investigated in order to find the etiology, since vascular occlusions are associated with systemic disorders, sometimes with an uncertain long-term vital prognosis.

Financial Disclosure:

None