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Purpose : To report a rare ocular manifestation of Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke syndrome (MELAS).
Methods : Case report
Results : A 17-year-old boy with underlying MELAS presented with severe headache and reduced hearing for one week. He had no ocular complaints or neurological deficits. He was referred for eye assessment after computed tomography showed multifocal occipital infarcts.
On examination, his best corrected visual acuity was 6/6 bilaterally, with normal optic nerve functions. Anterior segment examination and intraocular pressure were normal in both eyes. However, examination of left eye (LE) fundus revealed dilated, tortuous retinal veins with dot and blot hemorrhages in all retinal quadrants. The macula and optic discs were unremarkable, with a cup disc ratio of 0.3. No shunt vessels or pigmentory changes noted. Visual field examination was normal. He was diagnosed with LE non-ischemic central retinal vein occlusion.
Conclusion : MELAS is a multi-system neurodegenerative disorder with variable ocular involvement. Central retinal vein occlusion is a rare manifestation of this syndrome.
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