| 본문 : Background : Central retinal vein occlusion(CRVO) associated with ulcerative colitis(UC) is a rare disease and the treatment of UC-associated CRVO without macular edema by an injection of intravitreal dexamethasone has never been reported previously.
Case: A 40-year-old man with ulcerative colitis presented with sudden visual disturbances. An initial fundus examination showed subtle patchy yellow-to-white changes of the inner retina (supero-temporal to macular regions) and retinal hemorrhages around the superior vascular arcade and nasal to optic disc in his right eye. Optical coherence tomography showed an area of segmental hyper-reflectivity traversing the inner to outer plexiform layers of the macula. After 2 weeks, there was an increase in retinal hemorrhages and the development of cotton wool spots and optic disc swelling without any symptom improvement despite systemic corticosteroid administration. The patient was eventually diagnosed with nonischemic CRVO associated with UC. He eventually received sustained-release intravitreal dexamethasone, which led to the resolution of retinal hemorrhage, optic disc swelling, and cotton wool spots. Three months after the injection, retinal hemorrhages were not detectable. However, there was marked atrophy of the inner retina at the previous hyper-reflective area.
Conclusion: CRVO is an uncommon ophthalmologic manifestation associated with UC and should be included in the differential diagnosis of patients with ophthalmic complications associated with UC. Injection of intravitreal dexamethasone could be a viable treatment option for alleviating CRVO associated with UC, even without the presence of macular edema.
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