Case report: Branch retinal vein occlusion and primary antiphospholipid syndrome

BACKGROUND: Branch retinal vein occlusion (BRVO) is commonly encountered in older patients with vascular disease. This report presents a case of BRVO in an atypically young patient that precipitated additional testing and a subsequent diagnosis of primary antiphospholipid syndrome. This illustrates a need for a thrombophilic evaluation in atypical patients. CASE REPORT: A 33-year-old white man presented with a BRVO in the left eye. Laboratory studies found the presence of persistently elevated anticardiolipin immunoglobulin G and immunoglobulin M antibodies in the absence of causative systemic disease, conferring the diagnosis of primary antiphospholipid syndrome and supporting a thrombotic component of this BRVO. CONCLUSION: The presentation of a BRVO in young patients with minimal observable retinal effects from classic BRVO risk factors may indicate the necessity of a hematologic evaluation to determine possible compounding causes. Here we show a methodical inspection of the cause of an atypical BRVO and, more specifically, consideration for hypercoagulable pathologies and their treatment in such patient encounters. Optometry 2011;82:428-433