Central Retinal Vein Occlusion and Nonarteritic Ischemic Optic Neuropathy in 2 Patients with Mild Iron Deficiency Anemia

Abstract

We report on 2 patients with ophthalmologic complications associated with mild iron deficiency anemia. Case 1, a 37-year-old female patient, presented after 4 days of blurred vision in her left eye. Ophthalmoscopic and angiographic findings were consistent with the diagnosis of central retinal vein occlusion (CRVO). Further hematologic investigation into possible causes disclosed mild iron deficiency anemia (Hb 9.4 g/dl, hematocrit 30.5%). After the patient’s visual acuity had worsened progressively to 20/50, an initial thrombolytic treatment and continuous intravenous heparinization was started on day 8, followed by oral substitution therapy with ferrous sulfate. On day 14, her visual acuity recovered to 20/20 OS and remained stable during follow-up. Case 2, a 50-year-old female patient, presented with a 1-week-history of blurred vision and metamorphopsia. Her visual acuity was 20/200. Further examination revealed a nonarteritic ischemic optic neuropathy and an iron deficiency anemia as the underlying disease (Hb 7.3 g/dl, hematocrit 25%). Despite intravenous heparinization and systemic treatment with steroids, there was no improvement in visual acuity. Clinicians involved in the management of chronic iron deficiency anemia should be aware of possible ophthalmic manifestations in this disease.