title: Bilateral and simultaneous central retinal vein occlusion in a patient with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  To describe a case of bilateral and simultaneous central retinal vein occlusion (RVO) in a young patient diagnosed with obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  A 38-year-old man with morbid obesity and daytime sleepiness presented with a history of bilateral vision loss. His visual acuity (VA) was hand movements, and fundus examination (FE) revealed bilateral central RVO. General medical examination revealed untreated hypertension and type II respiratory failure. Laboratory tests for thrombophilia showed increased hematocrit (59%) and high levels of fibrinogen and C-reactive protein. Other causes of congenital and acquired hypercoagulability were ruled out. Pathologic polysomnography led to the diagnosis of OSAS. The patient was treated with antihypertensive drugs and continuous positive air pressure. In addition, he received intravitreal ranibizumab. At 10 months after presentation, his VA was no light perception in the right eye and hand movements in the left eye. FE revealed bilateral retinal and optic nerve atrophy, and the occurrence of a nonarteritic anterior ischemic neuropathy in the right eye was considered.
authors.affiliation: Department of Ophthalmology, Ourense University Hospital, Ourense, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Govetto
authors.affiliation: Department of Ophthalmology, Ourense University Hospital, Ourense, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Domínguez
authors.affiliation: Department of Ophthalmology, Ourense University Hospital, Ourense, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Rojas
authors.affiliation: Department of Hematology, Ourense University Hospital, Ourense, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Pereiro
authors.affiliation: Department of Ophthalmology, Ourense University Hospital, Ourense, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Lorente
keywords: Central retinal vein occlusion; Obstructive sleep apnea syndrome; Optic nerve atrophy; Visual acuity