A 47-year-old woman, with dyslipidemia, presented to the emergency department with sudden vision loss in the right eye. Visual acuity was 20/40 OD and 20/20 OS. Anterior segment, tonometry, and pupillary light reflex were unremarkable. Ophthalmoscopy of the right eye showed discretely blurred optic disc margins, tortuous and dilated retinal veins, and intraretinal hemorrhages in all quadrants; the left eye was unremarkable. An optical coherence tomography (OCT) scan showed a cystoid macular edema (CME) in the right eye; the left was unremarkable. Retinal nerve fiber layer thickness was 133 μm OD and 82 μm OS (reference value, 95.4 ± 10.48 μm).¹ A fluorescein angiography was scheduled. One week later, the patient returned to our department due to multiple episodes of amaurosis fugax in left eye. By that time, ophthalmoscopy disclosed a mild optic disc swelling, tortuous venous vessels, and retinal hemorrhages bilaterally (Figure 1). The OCT scan showed a CME spontaneous resolution in the right eye while the left eye was unremarkable. Fluorescein angiography revealed a slight delay in venous filling but no capillary nonperfusion areas. These features were compatible with bilateral nonischemic central retinal vein occlusion (CRVO), with spontaneous reperfusion in the right eye.

一名患有血脂异常的 47 岁女性因右眼突然失明而到急诊科就诊。视力为 20/40 OD 和 20/20 OS。眼前节、眼压计和瞳孔对光反射不明显。右眼检眼镜显示视盘边缘离散模糊，视网膜静脉曲折扩张，所有象限视网膜内出血；左眼不显眼。光学相干断层扫描 (OCT) 扫描显示右眼出现黄斑囊样水肿 (CME)；左边是不起眼的。视网膜神经纤维层厚度为 133 μm OD 和 82 μm OS（参考值，95.4 ± 10.48 μm）。¹安排了荧光素血管造影。1周后，患者因左眼多发一过性黑蒙返回我科。到那时，检眼镜检查显示双侧视盘轻度肿胀、静脉血管曲折和视网膜出血（图 1）。OCT 扫描显示右眼 CME 自发消退，而左眼无异常。荧光素血管造影显示静脉充盈稍有延迟，但无毛细血管非灌注区。这些特征与双侧非缺血性视网膜中央静脉阻塞 (CRVO) 兼容，右眼自发再灌注。