Bilateral central retina vein occlusion associated with obesity-hypoventilation syndrome (pickwickian syndrome).

PURPOSE: To describe bilateral central retinal vein occlusion (CRVO) as a clinical manifestation of obesity-hypoventilation syndrome (pickwickian syndrome).

METHOD: Case report.

PATIENT: A 37-year-old Hispanic man with morbid obesity and obstructive sleep apnea who suddenly developed bilateral loss of vision.

RESULTS

Laboratory studies disclosed the following: hematocrit, 81%; body mass index, 55 kg/m; PaCO2, 52 mmHg; and blood oxygen saturation (SaO2), 54%. Polysomnography demonstrated 45 obstructive apneas and 133 obstructive hypopneas, with abnormal movements of the inferior limbs during sleep.

DISCUSSION: Hypoxia and hypercapnia produce severe erythrocytosis that causes a change in blood viscosity. This may facilitate thrombus formation at the lamina cribrosa of both eyes manifested as bilateral CRVO.