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Tanya N. Turan, MD; Valérie Biousse, MD; Nancy J. Newman, MD

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We read with interest the recently published observation by Lee and colleagues.¹ The authors claim that their patient with cerebral venous thrombosis also had concomitant bilateral central retinal venous occlusion (CRVO), which was successfully treated with anticoagulation. Based on their report, the authors infer efficacy of low-molecular-weight heparin for the treatment of CRVO.

We have carefully reviewed the fundus photographs and the ophthalmologic findings and we have some concerns regarding the authors' diagnostic conclusions. Indeed, these findings are more suggestive of bilateral papilledema resulting from raised intracranial pressure rather than bilateral CRVO. Both optic nerves are swollen with exudates, cotton-wool spots, and peripapillary hemorrhages. The amount of swelling and optic nerve elevation is more than what is usually seen in CRVO. The venous dilation is moderate and is typically seen in severe papilledema. Furthermore, there are no retinal hemorrhages . . . [Full Text of this Article]

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RELATED LETTER

Central Retinal Venous Occlusion and Cerebral Venous Thrombosis—Reply
Young Hoon Lee and Jei Kim
Arch Neurol. 2007;64(4):609.
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