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Combined central retinal vein occlusion and cilioretinal artery occlusion in a patient on hormone replacement therapy
  1. Coventry and Warwickshire Hospital, Stoney Stanton Road, Coventry CV1 4FH
  1. D C Murray, Birmingham and Midland Eye Centre, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QU desiree{at}

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Editor,—Combined occlusion of the central retinal vein and the central retinal artery or a cilioretinal artery is unusual. There have been many previously reported systemic and ocular associations. The pathogenesis of this condition, however, is not established and remains controversial. Whether the venous obstruction or the arterial blockage acts as the initiating event is unknown. We describe a patient with combined central retinal vein occlusion (RVO) and cilioretinal artery occlusion occurring 6 weeks after starting hormone replacement therapy (HRT). We observed the evolution of the arterial occlusion. This suggests that the initiating event was the RVO.


A 46 year old patient presented with a 2 day history of decreased vision in the left eye noticed on waking. She reported no previous visual disturbances. She had been started on cyclical combined HRT 6 weeks before presentation. She was taking no other medication and had previously used the combined oral contraceptive pill with no adverse effects. She was a non-smoker. There was no past or family history of venous thromboembolism.

Visual acuities …

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