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The purpose of this manuscript is to report a rare case of pediatric central retinal artery occlusion (CRAO) in the setting of atypical hypercoagulable tests. An 11-year-old female presented to the emergency department with painless, visual changes in the left eye. Ophthalmological examination was remarkable for a central area of retinal ischemia and edema with sparing along the distribution of the cilioretinal artery along with a cherry red spot, all of which were consistent with a CRAO.

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Background: Central retinal vein occlusion and cilioretinal artery occlusion are rare but serious ocular conditions that can lead to significant visual impairment. While few cases of central retinal vein occlusion and cilioretinal artery occlusion have been individually reported, concurrent occlusion of both vessels is extremely rare, particularly in younger patients without traditional vascular risk factors. We present the first reported case of simultaneous central retinal vein occlusion and cilioretinal artery occlusion in a young female patient associated with short-term use of progestin-only oral contraceptives (OCPs).

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Concurrent Cilioretinal Artery Occlusion in Acute Toxoplasma Chorioretinitis.

Am J Ophthalmol

January 2025

Harvard Retinal Imaging Lab, Harvard Medical School, Boston, Massachusetts, USA; Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA. Electronic address:

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Article Synopsis
  • PAH can cause serious ocular conditions like CRVO and CilRAO due to high blood pressure in the lungs affecting blood flow to the eyes.
  • A 13-year-old girl with a history of heart surgery experienced sudden vision loss, with tests revealing both CRVO and CilRAO, along with signs of severe PAH.
  • Treatment with Bosentan and traditional Chinese medicine led to significant vision improvement, highlighting the importance of addressing cardiovascular issues to prevent eye complications and the need for a comprehensive approach in such complex cases.
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We present 2 clinical cases of central retinal vein occlusion (CRVO) combined with cilioretinal artery occlusion (CRAO) in young patients with no cardiovascular risk factors (CVRF) or medical history of interest. An extensive etiological study with analytical and imaging tests was performed without finding relevant alterations. Finally, in the first case, the intake of 1 postcoital contraceptive pill was considered the triggering cause while, in the second case, the etiology was attributed to a previous infection by the SARS-Cov-2 virus.

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