Central retinal vein occlusion – A patient with systemic sclerosis

Jelena Karadžić; Aleksandra Radosavljević; Igor Kovačević

doi:10.2298/VSP141028073K

Jelena Karadžić Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia
Aleksandra Radosavljević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Igor Kovačević Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP141028073K

Keywords: scleroderma, systemic, retinal vein occlusion, diagnosis, angiogenesis inhibitors, treatment outcome,

Abstract

Introduction. Scleroderma (systemic sclerosis) is a severe chronic connective tissue disease, which results in involvement of numerous internal organs. Changes in the eye are the consequences of organ-specific manifestations of scleroderma or adverse effects of immunosuppressive treatment applied. Case report. We reported a 42-year-old woman with systemic sclerosis and acute deterioration of vision in the left eye, with visual acuity 0.9. After thorough clinical examination, including fluorescein angiography and optical coherence tomography, the diagnosis of nonischemic central retinal vein occlusion was made. Further biochemical, rheumatological and immunological investigation, apart from inactive systemic sclerosis, showed normal findings. Therefore, the cause of central retinal vein occlusion could only be attributed to the microvascular changes in systemic sclerosis. After three months, visual acuity deteriorated to 0.6 due to the development of cystoid macular edema. The patient received intravitreal injection of bevacizumab and after a single dose visual acuity improved to 0.9. After a 6-month follow-up, macular edema resolved and visual acuity stabilized. Conclusion. According to our knowledge and current data from the literature, central retinal vein occlusion is a rare vision threatening manifestation of scleroderma. There are only few published case reports on central vein occlusion in scleroderma patients. Examination of the ocular fundus is recommended for evaluation of vascular disease in patients with systemic sclerosis.

Author Biographies

Jelena Karadžić, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia

Medical retina department, ophthalmology specialist

Aleksandra Radosavljević, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Uveitis department, ophthalmology specialist, clinical assistant

Igor Kovačević, Clinic for Eye Diseases, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Vitreoretinal surgery and trauma department, ophthalmology specialist, clinical assistant

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