Cavernous sinus thrombosis elicited by a central retinal vein venous stasis retinopathy.
BACKGROUND
Central retinal vein occlusion is a relatively common retinal disorder in the elderly, and those with cardiovascular or thrombophilic risk factors are at increased risk. Although still unsatisfying, some treatments for the acute and chronic phases have been established based on randomized studies. However, for rare conditions mimicking central retinal vein occlusion, treatment of the acute phase should be targeted at etiology. A rare condition mimicking central retinal vein occlusion in a 70-year-old man is presented and discussed.


METHODS
A 70-year-old man was admitted to the hospital for isovolemic hemodilution related to a central retinal vein occlusion of the elderly, after a sudden decrease in visual acuity to 0.1.


RESULTS
Clinical and laboratory work-up demonstrated a venous stasis retinopathy, related to an atypical cavernous sinus thrombosis of undetermined origin. The patient had experienced in the past 6 months intermittent diplopia and an irreducible conjunctival hyperemia. Hemodilution was dismissed. Soon after initiation of anticoagulation therapy, the patient's clinical signs and symptoms improved. Final visual acuity was 0.8.


CONCLUSIONS
Venous stasis retinopathy secondary to cavernous sinus thrombosis is rare. However, careful clinical examination and extensive laboratory work-up is needed to exclude central retinal vein occlusion not associated with common vascular pathologies of the elderly.
Zaninetti
Marc
M
Hôpital Ophtalmique Jules-Gonin, 1004 Lausanne, Switzerland.
Stangos
Alexandros N
AN
Abdo
German
G
Pournaras
Constantin J
CJ
D000368:Aged; D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use; D001810:Blood Volume; D020226:Cavernous Sinus Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003374:Coumarins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005451:Fluorescein Angiography; D006438:Hemodilution; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012169:Retinal Vein / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014792:Visual Acuity
D000925:Anticoagulants; D003374:Coumarins; D006493:Heparin; C030123:coumarin