title: Polycythemia causing posterior segment vascular occlusions.
abstract: A 44-year-old male patient presented with features suggestive of transient central retinal artery occlusion (CRAO) followed by permanent CRAO and lateral posterior ciliary artery occlusion. He had diagnostic features of polycythemia vera (PV). When presented for the first time, the patient had features of ocular ischemia such as ocular pain, conjunctival congestion, and retinal opacification but with normal arm-to-retina time and normal arteriovenous transit time. During the second presentation, he had ocular pain, congested conjunctiva, retinal opacification, cherry red spot with box-carrying of retinal vessels, and choroidal infarct (Amalric's sign). He had lost light perception in that eye. Patients with polycythemia are prone to multifocal vascular occlusions and this can be the presenting feature in PV. A timely diagnosis and prompt management can prevent these repeated thromboembolic occlusive episodes.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.
authors.forename: Suganeswari
authors.initials: S
authors.lastname: Ganesan
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Raman
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
keywords: Amalric sign; central retinal artery occlusion; lateral posterior ciliary artery occlusion; polycythemia