Neovascular glaucoma associated with central retinal vein occlusion in a young patient with hyperlipidemia.

Abstract

This case report presents a rare instance of neovascular glaucoma secondary to central retinal vein occlusion in a previously healthy man in his early 30s who exhibited acute unilateral vision loss, ocular pain, and elevated intraocular pressure. Ophthalmic imaging, including ultra-widefield fundus photography and optical coherence tomography, revealed retinal hemorrhages, intraretinal fluid, and iris neovascularization consistent with ischemic central retinal vein occlusion and secondary neovascular glaucoma. Notably, systemic evaluation revealed severe hyperlipidemia associated with the patient's strict nonvegetarian diet, with no other identifiable risk factors. Treatment included intravitreal antivascular endothelial growth factor injections, Ahmed glaucoma valve implantation, and panretinal photocoagulation followed by pars plana vitrectomy. The patient experienced partial visual recovery after the initiation of lipid-lowering therapy and dietary counseling. This case underscores the importance of considering modifiable metabolic factors, particularly extreme dietary patterns, in young patients presenting with central retinal vein occlusion. It supports the incorporation of systemic lipid screening and dietary assessment into the diagnostic workup of atypical retinal vascular events. Although causality cannot be established, this case advocates the need for further investigation into the systemic implications of diet-related hyperlipidemia in ocular vascular disease.