Central retinal vein occlusion revealing celiac disease: Fir
Published in the Indian Journal of Ophthalmology, the authors report two cases of 35-year and 25-year-old females presented with visual acuity of 6/60 and 5/60 for the right and left eye on Snellen's chart. On evaluation, both eyes showed central retinal vein occlusion (CRVO). The fundus fluorescein angiography revealed delayed venous filling and blocked fluorescence with no evidence of neovascularization.

The optical coherence tomography showed cystoid macular edema. Investigations for Case 1 revealed marked iron deficiency anemia and thrombocytosis and for Case 2 showed moderate anemia. On physician evaluation, serum antitissue transglutaminase antibody titers were done due to suspicion of celiac disease (CD), which was highly positive.

Upper gastrointestinal endoscopy showed scalloping of duodenal folds and loss of villi and thus duodenal biopsy was performed which showed signs of atrophic villi, decreased villous/crypt ratio (<1.1), and cryptic hyperplasia graded as Modified Marsh Grade Type 3c, confirming the diagnosis of CD.

The patients were managed with gluten-free diet and iron and folate supplementation and each eye underwent intravitreal bevacizumab (1.25 mg/0.5 ml) for the management of CME which showed improvement in vision, resolution of hemorrhages and CME over subsequent follow-ups.

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