A case of progressive occlusion of retinal vessels in a young adult

We report a case of bilateral progressive occlusion of retinal vessels in a 28-year-old female. The patient complained of seeing 'flying flies' in both eyes. At the initial examination, a few inflammatory cells were noted in the anterior chamber and vitreous. Retinal vessels were tortuous and irregularly decreased in caliber (narrowed), and dot hemorrhages were visible in both fundi. Fluorescein angiography showed occlusion of retinal vessels peripheral to the equator, arteriovenous anastomosis, and leakage of dye from vessels in both eyes. The patient was prescribed systemic fibrinolytic drugs, antiplatelet aggregation drugs, antiviral agents, and corticosteroid drugs, and she underwent stellate ganglion block and laser photocoagulation of areas with occluded vessels in both eyes. However, vascular occlusion progressed, resulting in recurrent vitreous hemorrhage that did not absorb. Vitrectomy was performed and resulted in improvement in visual acuity and no further vascular occlusion. No systemic abnormalities were identified in this patient and the etiology of her retinal vessel occlusion remains unknown.