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CASE REPORT
Year : 2018  |  Volume : 66  |  Issue : 10  |  Page : 1498-1501

Bilateral combined central retinal artery and vein occlusion in a 3-year-old child with nephrotic syndrome


1 Department of Pediatric Retina, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
2 Department of Pediatrics, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Anand Vinekar
Department of Pediatric Retina, Narayana Nethralaya Eye Institute, Bengaluru- - 560 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1332_17

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Nephrotic syndrome (NS) is a common disease of childhood but ophthalmic manifestations are seldom reported. We report a rare occurrence of bilateral combined central retinal artery and vein occlusion in a 3-year-old with NS. The child presented with bilateral painless loss of vision, central pallid retinae with cherry red spots, vascular tortuosity, and retinal hemorrhages. There was delayed filling of the arteriolar circulation and a delay in arteriovenous transit time on angiography and increased central retinal thickening on optical coherence tomography. She was treated with oral steroids, subcutaneous low molecular weight heparin, and oral acetylsalicylic acid. The central retinae showed resolution of the hemorrhages, tortuosity, edema, and pallor within 3 weeks. Visual acuity recovered bilaterally to 20/360, 20/190, and 20/40 at 1, 3, and 6 weeks, respectively. We discuss the possible reasons for good recovery in our patient. Though bilateral combined central retinal artery and vein occlusion is rare in pediatric NS, the treating physician should be aware of this entity as it can be successfully managed.


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