Intensive immunosuppression treatment for central retinal vein occlusion in a young adult: a case report.
OBJECTIVE
To describe a case of severe central retinal vein occlusion (CRVO) in a young patient, in whom intensive immunosuppressive therapy improved the clinical outcome.


METHODS
A 35-year-old men presented with a first episode of CRVO in his right eye in 1990. Despite corticosteroids and laser treatment, rubeotic glaucoma developed and the eye had to be enucleated. Seven years later, CRVO developed in the fellow eye, with venous tortuosity and haemorrhages. An extensive systemic workup was unremarkable. Corticosteroids failed to control the clinical situation. Cells were seen in the anterior vitreous. Visual acuity decreased to 2/60. Cyclosporine and azathioprine were added, but did not prevent recurrences. Campath-1H treatment was then started and visual acuity improved to 6/36. In November 2000, visual acuity was 6/24 and haemorrhages had cleared.


CONCLUSIONS
Many authors have proposed a role for inflammation in the pathophysiology of CRVO in young patients. However, there is no general agreement on corticosteroid use in these patients. Our case illustrates that, in some settings, high-dose corticosteroids and intensive immunosuppression might be used successfully to preserve vision.
Willermain
François
F
Department of Ophthalmology, University of Aberdeen, Scotland, UK.
Greiner
Kathrin
K
Forrester
John V
JV
D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005451:Fluorescein Angiography; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use*; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine