Rare presentation of central retinal vein occlusion sparing the superotemporal quadrant in a patient with congenital cardiovascular disease

Abstract

A young Asian man with a diagnosis of complex congenital heart disease and visceral situs inversus presented to the eye casualty with a recent onset of blurred vision in his left eye. Funduscopic examination of the left eye showed the presence of intraretinal haemorrhages in the inferior and superonasal quadrants, sparing the superotemporal arcade. Optical coherence tomography showed presence of macular oedema and fundus fluorescein angiography confirmed the diagnosis of central retinal vein occlusion sparing the superotemporal branch. Intravitreal antivascular endothelial growth factor treatment was administered, with favourable anatomic and functional outcomes. The presentation of an incomplete central retinal vein occlusion is extremely unusual, especially in a patient with significant cardiac malformation. With the current advances in interventional cardiac procedures, more patients are having longer lifespan and are presenting to ophthalmologists with ocular consequences of circulatory disorders, emphasising the need for multidisciplinary management.