| 발표일자: |
2019년 4월 5일(금)~7(일) |
| 발표번호: |
P(e-poster)-029 |
| 발표장소: |
벡스코 전시장 1홀 내 |
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| factor VIII 수치가 증가된 환자에서 망막중심동맥과 중심정맥의 폐쇄 1예 |
| 인제대학교 의과대학 부산백병원 안과학교실, 인제대학교 의과대학 부산백병원 안과질환 T2B 기반구축센터, 인제대학교 의과대학 해운대백병원 안과학교실 |
| 이정후(1,2), 김현웅 (3), 장인범(1,2) |
| 본문 : Background: To report a case of unilateral central retinal vein occlusion (CRVO) with Central retinal artery occlusion (CRAO) in a patient with elevated Factor VIII.
Case presentation: A 48-year-old woman presented with a complaint of decreased visual acuity in her left eye that began six weeks prior. The patient had diabetes. The best-corrected visual acuity (BCVA) was hand motion and the intraocular pressure (IOP) was 34 mmHg in the left eye. There was a neovascularization of the iris in the left eye. Otherwise, there was no specific finding of anterior segment on slit lamp examination in the right eye. A complete fundus evaluation including fluorescein angiography showed non-proliferative diabetic retinopathy in the right eye and CRVO with CRAO in the left eye. Systemic evaluation revealed elevated fibrinogen and Factor VIII suggestive of the diagnosis of thrombophilia due to elevated Factor VIII. This symptom was the first sign of the underlying disorder. IOP was normalized one week after IOP lowering agents were applied. Intravitreal anti-vascular endothelial growth factor treatment and pan-retinal photocoagulation were performed in the left eye. Additionally, to treat thrombophilia, warfarin treatment was started and flame shaped retinal hemorrhage with cotton wool patch near the optic disc and around the retinal vascular arcade at the posterior pole had occurred in the right eye during treatment. Then, warfarin treatment was discontinued and retinal hemorrhage was decreased in the right eye. In the left eye, the BCVA did not change during treatment.
Conclusions: Combined CRVO and CRAO is very uncommon and such cases have mostly been attributed various causes like thrombophilia, retinal vasculitis, and mechanical compression. Elevated levels of Factor VIII as an independent risk in the development of venous thromboembolism. Combined cases usually present with severe visual loss and such patients should be thoroughly evaluated to diagnose underlying factors including Factor VIII, and initiate appropriate management at the earliest. |
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