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Letter to the Editor
Delayed diagnosis of homocystinuria as a cause of vascular retinal occlusion in young adults
  1. ELZBIETA W MOLICKA,
  2. HENK VAN SLOOTEN
  1. Diaconessenhuis Leiden, Netherlands
  2. FC Donders Institute, Academic Hospital Utrecht, Netherlands
  3. Diaconessenhuis Leiden, Netherlands and Department of Ophthalmology, Free University, Amsterdam, Netherlands
  1. ALLEGONDA VAN DER LELIJ
  1. Diaconessenhuis Leiden, Netherlands
  2. FC Donders Institute, Academic Hospital Utrecht, Netherlands
  3. Diaconessenhuis Leiden, Netherlands and Department of Ophthalmology, Free University, Amsterdam, Netherlands
  1. MARIA S A SUTTORP-SCHULTEN
  1. Diaconessenhuis Leiden, Netherlands
  2. FC Donders Institute, Academic Hospital Utrecht, Netherlands
  3. Diaconessenhuis Leiden, Netherlands and Department of Ophthalmology, Free University, Amsterdam, Netherlands
  1. Dr M S A Suttorp-Schulten, MD, Department of Ophthalmology, Free University Hospital Amsterdam, PO Box 7057, 1007 MB Amsterdam, Netherlands

https://doi.org/10.1136/bjo.83.11.e1306

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    Editor,—Retinal vascular occlusions in young adults are seen very infrequently and are generally associated with systemic disorders.1 Diagnosis of the underlying disease is very important because of treatment and prevention of recurrence.2 We report two cases initially presenting with systemic neurological disease. Both developed retinal vascular occlusions and the diagnosis of the underlying cause was only made afterwards.

    CASE REPORTS

    A 30 year old, obese woman presented to the neurologist with acquired perceptive deafness, a tetrapyramidal syndrome, with gait problems and urinary incontinence. Multiple sclerosis was considered, but cerebral magnetic resonance imaging scan showed only atypical lesions. Symptoms gradually decreased without disappearing completely. Six months later an occlusion of the retinal nasal inferior artery occurred in the right eye, visual acuity was 20/20 in both eyes (Fig …

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