gms | German Medical Science

Background: To describe a patient with Wegener's Granulomatosis, who developed unilateral Central Retinal Vein Occlusion (CRVO) without clinical evidence of intraocular inflammation.

Methods: A 54-year-old man developed unilateral non-ischemic CRVO associated with systemic Wegener's Granulomatosis, which had been in remission since one year. Fluorescein angiography revealed no sign of retinal vasculitis. Visual acuity was reduced to 6/10 due to diffuse macular edema. No other vascular risk factors were identified. Isovolemic hemodilution and systemic immunosuppression with prednisolon oral were initiated.

Results: After 3 months the diffuse leckage at the posterior pole was reduced, but vision dropped to 2/10 due to development of cystoid macular edema. 3 months after grid laser photocoagulation leckage was significantly reduced and vision improved to 3/10. 4 months after intravitreal injection of 10 mg triamcinolone acetonide no further leckage in the macular was detected and vision was stabilized at 5/10.

Conclusions: Wegener`s Granulomatosis should be considered in the differential diagnosis of CRVO in the young age group. In those patients intravitreal triamcinolone acetonide seems to be a good adjunct to systemic immunosuppressive therapy. Only 5 cases with isolated CRVO in Wegener´s granulomatosis have been reported in literature so far. In these patients the lack of clinical evidence of retinal vasculitis was explained by a postulated compression of the central retinal vein in a laminar or retrolaminar location by extracapillary granulomatous inflammation.Financial interests of the authors are disclosed.