Combined Central Retinal Vein and Artery Occlusion Following Head Trauma: A Case Report.

PURPOSE: To describe a case of combined central retinal vein and artery occlusion following a motor vehicle accident.

METHODS

The patient's medical history, exam findings, and lab and imaging results were reviewed through an electronic medical record.

RESULTS

A 14-year-old female presented with blunt head trauma after a motor vehicle-pedestrian collision and was found to have a left frontal epidural hematoma with midline shift, extensive skull fractures, and impending uncal herniation resulting in clinical deterioration and seizure activity. The patient underwent emergent craniotomy. Initial ophthalmic exam revealed corneal abrasions without globe injury. By hospital day 4, the patient noticed unilateral acute vision decline and the ophthalmology team was consulted. Visual acuity in the left eye was counting fingers, and retinal hemorrhages, macular whitening, and tortuous vessels were seen on exam. Optical coherence tomography and fluorescein angiography 5 days later confirmed combined central retinal artery and vein occlusion. Hematologic workup and neuroimaging were unrevealing. By 9-month follow-up, retinal hemorrhages had resolved and left eye visual acuity improved to 20/300.

CONCLUSION

Combined central retinal vein and artery occlusion is a potential ophthalmic complication of significant head and ocular trauma, warranting careful monitoring by ophthalmologists.