Combined Central Retinal Vein Occlusion and Cilioretinal Artery Occlusion As the Initial Presentation of Frosted Branch Angiitis: a Case Report and Literature Review

Overview

Journal J Ophthalmic Inflamm Infect

Publisher Springer

Specialty Ophthalmology

Date 2023 May 25

PMID 37227553

Authors

Abdullah Albahlal

Waleed Khayyat

Sulaiman M Alsulaiman

Affiliations

Soon will be listed here.

Abstract

Purpose: To report a case of combined central retinal vein occlusion (CRVO) with cilioretinal artery occlusion (CLRAO) that heralded the development of frosted branch angiitis (FBA).

Case Report: A 25-year-old healthy male presented with sudden painless visual loss in his left eye with a visual acuity (VA) of 20/300. Fundus exam and fluorescein angiography showed signs of combined CRVO and CLRAO. Without treatment, his vision gradually improved until it reached 20/30 within four months. Five months after initial presentation, he returned with severe visual loss (20/400) in the same eye and a clinical picture of severe occlusive periphlebitis resembling a frosted branch angiitis pattern associated with severe macular edema. This was promptly and successfully treated with systemic steroids and immunosuppressive medications.

Conclusion: CRVO in young population can have an unusual course and one should carefully rule out underlying uveitic etiologies in each visit. Clinical suspicion and close follow‑up are required for early detection and timely management of FBA.

Citing Articles

Case report: Cilioretinal artery occlusion combined with central retinal vein occlusion as the initial presentation of pulmonary arterial hypertension.

Gao Y, Xie X, Li J, Mu Q, Wang X, Wang S Front Med (Lausanne). 2025; 11:1493834.

PMID: 39760041 PMC: 11695289. DOI: 10.3389/fmed.2024.1493834.

References

Shimura M, Yasuda K, Nakazawa T, Abe T, Shiono T, Iida T . Panretinal photocoagulation induces pro-inflammatory cytokines and macular thickening in high-risk proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2009; 247(12):1617-24. DOI: 10.1007/s00417-009-1147-x. View

Foss A, Headon M, Hamilton A, Lightman S . Transient vessel wall sheathing in acute retinal vein occlusions. Eye (Lond). 1992; 6 ( Pt 3):313-6. DOI: 10.1038/eye.1992.62. View

. A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report. Ophthalmology. 1995; 102(10):1434-44. View

Kaburaki T, Nakamura M, Nagasawa K, Nagahara M, Joko S, Fujino Y . Two cases of frosted branch angiitis with central retinal vein occlusion. Jpn J Ophthalmol. 2002; 45(6):628-33. DOI: 10.1016/s0021-5155(01)00416-6. View

Kumawat B, Tripathy K, Venkatesh P, Chawla R, Sharma Y . Central Retinal Vein Occlusion-like Appearance: A Precursor Stage in Evolution of Frosted Branch Angiitis. J Ophthalmic Vis Res. 2017; 12(4):440-442. PMC: 5644415. DOI: 10.4103/jovr.jovr_84_15. View

Ramachandran R, Hughes E, Larkin G, Graham E, Stanford M, Lim M . Secondary frosted branch angiitis in neuro-Behçet's disease with serous macular detachment. Pediatr Int. 2011; 53(2):285-6. DOI: 10.1111/j.1442-200X.2011.03343.x. View

Satoh S, Itoh C, Nakamura N . [A case of frosted branch angiitis associated with retinal vein occlusion as a complication of familial Mediterranean fever]. Nippon Ganka Gakkai Zasshi. 2010; 114(7):621-8. View

Kleiner R . Frosted branch angiitis: clinical syndrome or clinical sign?. Retina. 1997; 17(5):370-1. DOI: 10.1097/00006982-199709000-00002. View

Hayreh S, Klugman M, Podhajsky P, Servais G, PERKINS E . Argon laser panretinal photocoagulation in ischemic central retinal vein occlusion. A 10-year prospective study. Graefes Arch Clin Exp Ophthalmol. 1990; 228(4):281-96. DOI: 10.1007/BF00920049. View

10.

Portero A, Herreras J . Frosted branch angiitis diagnosed as neuro-behçet: a diagnostic and etiologic dilemma. Case Rep Ophthalmol. 2011; 2(2):170-5. PMC: 3104864. DOI: 10.1159/000328747. View

11.

Kleiner R, Kaplan H, Shakin J, Yannuzzi L, Crosswell Jr H, McLean Jr W . Acute frosted retinal periphlebitis. Am J Ophthalmol. 1988; 106(1):27-34. View

12.

. The International Criteria for Behçet's Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2013; 28(3):338-47. DOI: 10.1111/jdv.12107. View

13.

Walker S, Iguchi A, Jones N . Frosted branch angiitis: a review. Eye (Lond). 2004; 18(5):527-33. DOI: 10.1038/sj.eye.6700712. View

14.

Renard E, Chiquet C, Bouillet L, Romanet J . [Frosted-branch angiitis revealing Behçet's disease]. J Fr Ophtalmol. 2009; 32(9):664-8. DOI: 10.1016/j.jfo.2009.04.030. View

15.

Al-Mujaini A, Wali U . Frosted branch angiitis, neuroretinitis as initial ocular manifestation in Behçet disease. Indian J Ophthalmol. 2011; 59(3):240-1. PMC: 3120249. DOI: 10.4103/0301-4738.81048. View

16.

Itaya M, Sakurai E, Nozaki M, Yamada K, Yamasaki S, Asai K . Upregulation of VEGF in murine retina via monocyte recruitment after retinal scatter laser photocoagulation. Invest Ophthalmol Vis Sci. 2007; 48(12):5677-83. DOI: 10.1167/iovs.07-0156. View

17.

Posarelli C, Arapi I, Figus M, Neri P . Biologic agents in inflammatory eye disease. J Ophthalmic Vis Res. 2012; 6(4):309-16. PMC: 3306110. View

18.

Greifner G, Neri P, Amer R . Frosted branch angiitis complicated by retinal vein occlusion: clinical course and long-term visual outcome. Graefes Arch Clin Exp Ophthalmol. 2016; 254(3):541-4. DOI: 10.1007/s00417-015-3255-0. View

19.

Reynders S, Dewachter A, De Vriese A . A case of secondary frosted branch angiitis in Behçet's disease. Bull Soc Belge Ophtalmol. 2006; (298):41-4. View

20.

Takahashi A, Nagaoka T, Sato E, Yoshida A . Effect of panretinal photocoagulation on choroidal circulation in the foveal region in patients with severe diabetic retinopathy. Br J Ophthalmol. 2008; 92(10):1369-73. DOI: 10.1136/bjo.2007.136028. View