Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review

Branch retinal vein occlusion (BRVO) and branch retinal artery occlusion (BRAO) are two distinct yet serious retinal vascular disorders that often present with acute visual impairment. While both conditions are commonly encountered independently, their simultaneous or sequential occurrence in opposi...

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Main Authors: Chao Zhang, Han Wang, Zhiyu Xu, Qiwei Lu, Ying Zhu, Jun Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1615871/full
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author Chao Zhang
Han Wang
Zhiyu Xu
Qiwei Lu
Ying Zhu
Jun Li
author_facet Chao Zhang
Han Wang
Zhiyu Xu
Qiwei Lu
Ying Zhu
Jun Li
author_sort Chao Zhang
collection DOAJ
description Branch retinal vein occlusion (BRVO) and branch retinal artery occlusion (BRAO) are two distinct yet serious retinal vascular disorders that often present with acute visual impairment. While both conditions are commonly encountered independently, their simultaneous or sequential occurrence in opposite eyes of the same patient is exceedingly rare and poses unique diagnostic and therapeutic challenges. Here, we present the case of a 65-year-old male patient with a history of systemic hypertension who developed BRAO in the right eye and BRVO in the left eye within a short time interval. Detailed ophthalmologic examination, multimodal imaging including optical coherence tomography (OCT) and fundus fluorescein angiography (FFA), and systemic vascular assessments such as carotid Doppler ultrasonography and cardiac evaluation were performed to identify the underlying etiology and guide treatment decisions. The patient was found to have significant carotid atherosclerosis with plaque formation, suggesting systemic vascular pathology as a shared risk factor for both events. Ocular treatment involved posterior sub-Tenon injection of corticosteroids, vasodilator therapy, and laser photocoagulation for ischemic areas. Visual acuity showed marked improvement in both eyes after appropriate interventions and systemic blood pressure control. The concurrent presentation of BRVO and BRAO in different eyes may reflect a systemic vascular disease burden and warrants a high index of suspicion for underlying cardiovascular or cerebrovascular abnormalities. This case underscores the importance of prompt ocular diagnosis, thorough systemic evaluation, and multidisciplinary collaboration to prevent further vascular events and preserve visual function. A detailed literature review is also provided to contextualize the clinical features, diagnostic tools, management approaches, and prognosis of such rare bilateral retinal vascular presentations.
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spelling doaj-art-a65bdad1508f465391d548e9d2fb5b0d2025-08-20T02:41:26ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16158711615871Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature reviewChao Zhang0Han Wang1Zhiyu Xu2Qiwei Lu3Ying Zhu4Jun Li5Department of Ophthalmology, The Third People's Hospital of Dalian, Dalian, Liaoning, ChinaDepartment of Ophthalmology, The Third People's Hospital of Dalian, Dalian, Liaoning, ChinaDepartment of Ophthalmology, The Third People's Hospital of Dalian, Dalian, Liaoning, ChinaDepartment of Ophthalmology, The Third People's Hospital of Dalian, Dalian, Liaoning, ChinaDepartment of Ophthalmology, The Third People's Hospital of Dalian, Dalian, Liaoning, ChinaDepartment of Retina, He Eye Specialists Hospital of Shenyang, Shenyang, ChinaBranch retinal vein occlusion (BRVO) and branch retinal artery occlusion (BRAO) are two distinct yet serious retinal vascular disorders that often present with acute visual impairment. While both conditions are commonly encountered independently, their simultaneous or sequential occurrence in opposite eyes of the same patient is exceedingly rare and poses unique diagnostic and therapeutic challenges. Here, we present the case of a 65-year-old male patient with a history of systemic hypertension who developed BRAO in the right eye and BRVO in the left eye within a short time interval. Detailed ophthalmologic examination, multimodal imaging including optical coherence tomography (OCT) and fundus fluorescein angiography (FFA), and systemic vascular assessments such as carotid Doppler ultrasonography and cardiac evaluation were performed to identify the underlying etiology and guide treatment decisions. The patient was found to have significant carotid atherosclerosis with plaque formation, suggesting systemic vascular pathology as a shared risk factor for both events. Ocular treatment involved posterior sub-Tenon injection of corticosteroids, vasodilator therapy, and laser photocoagulation for ischemic areas. Visual acuity showed marked improvement in both eyes after appropriate interventions and systemic blood pressure control. The concurrent presentation of BRVO and BRAO in different eyes may reflect a systemic vascular disease burden and warrants a high index of suspicion for underlying cardiovascular or cerebrovascular abnormalities. This case underscores the importance of prompt ocular diagnosis, thorough systemic evaluation, and multidisciplinary collaboration to prevent further vascular events and preserve visual function. A detailed literature review is also provided to contextualize the clinical features, diagnostic tools, management approaches, and prognosis of such rare bilateral retinal vascular presentations.https://www.frontiersin.org/articles/10.3389/fmed.2025.1615871/fullbranch retinal vein occlusionbranch retinal artery occlusionretinal ischemiavascular risk factorsdiabeteshypertension
spellingShingle Chao Zhang
Han Wang
Zhiyu Xu
Qiwei Lu
Ying Zhu
Jun Li
Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
Frontiers in Medicine
branch retinal vein occlusion
branch retinal artery occlusion
retinal ischemia
vascular risk factors
diabetes
hypertension
title Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
title_full Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
title_fullStr Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
title_full_unstemmed Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
title_short Unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion: a case report and comprehensive literature review
title_sort unilateral branch retinal vein occlusion and contralateral branch retinal artery occlusion a case report and comprehensive literature review
topic branch retinal vein occlusion
branch retinal artery occlusion
retinal ischemia
vascular risk factors
diabetes
hypertension
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1615871/full
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