[Bilateral central retinal vein occlusion and circulating anticoagulant].

A case of central retinal vein occlusion with second development of the same type of retinal vein occlusion in the fellow eye, is reported. The patient was a 68 year-old man with a history of thyroid gland disorder and a cardiac arrhythmia. He presented also with bilateral tilted disc. The first eye occlusion was initially nonischemic, but converted secondarily into an ischemic type and required laser panretinal photocoagulation. The biological assay found the presence of lupus anticoagulant antibodies and rheological findings (major plasma hyperviscosity, increased erythrocyte aggregation, high hematocrit and fibrinogen levels). The patient was given high doses of troxerutin, and aspirin. Central retinal vein occlusion occurred in the fellow eye one year later, a few weeks after the decrease of troxerutin doses. Hemodilution therapy was performed and visual acuity remained unchanged. Unusual risk factors for retinal vein occlusion are discussed. Lupus anticoagulant antibodies may sometimes lead to occlusive vascular phenomenon. Although these antibodies are not commonly found in retinal vascular occlusion, they may constitute a contributory factor. Tilted disc has often been involved in the pathogenesis of central retinal vein occlusion. Finally, abnormal rheological findings, major in this case, are found in more than half of the cases of retinal vein occlusion.