Unusual Case of Bilateral Combined Retinal Vein and Artery Occlusion – Presumably due to Leech Therapy by Hirudo medicinalis

Introduction

Retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. Combined retinal vein and artery occlusion is a rare entity that causes severe vision loss. It may develop due to systemic causes such as diabetes, hypertension, dyslipidemia, or thrombophilic and septic events such as factor V Leiden mutation [1]. The prognosis is relatively poor, with complications such as neovascular glaucoma and rubeosis iridis [2]. Systemic evaluation is the cornerstone that guides the treatment; hence, the systemic cause must be revealed. The case reported here is of a patient with combined retinal vein and artery occlusion, presumably due to leech therapy by Hirudo medicinalis.

Publikationsverlauf

Eingereicht: 14. Juni 2023

Angenommen: 04. Dezember 2023

Accepted Manuscript online:
07. Dezember 2023

Artikel online veröffentlicht:
14. Februar 2024

• References

• 1 Schmidt D. Comorbidities in combined retinal artery and vein occlusions. Eur J Med Res 2013; 18: 27
• 2 Hayreh SS. Neovascular glaucoma. Prog Retin Eye Res 2007; 26: 470-485
• 3 Menage MJ, Wright G. Use of leeches in a case of severe periorbital haematoma. Br J Ophthalmol 1991; 75: 755-756
• 4 Herlin C, Bertheuil N, Bekara F. et al. Leech therapy in flap salvage: Systematic review and practical recommendations. Ann Chir Plast Esthet 2017; 62: e1-e13
• 5 Joslin J, Biondich A, Walker K. et al. A Comprehensive Review of Hirudiniasis: From Historic Uses of Leeches to Modern Treatments of Their Bites. Wilderness Environ Med 2017; 28: 355-361
• 6 McCracken JA, Koehler SM, Sharma R. Rethinking antimicrobial prophylaxis in patients receiving medicinal leech therapy. Am J Health Syst Pharm 2022; 79: e14-e19
• 7 Fenollar F, Fournier PE, Legre R. Unusual case of Aeromonas sobria cellulitis associated with the use of leeches. Eur J Clin Microbiol Infect Dis 1999; 18: 72-73
• 8 Ouderkirk JP, Bekhor D, Turett GS. et al. Aeromonas meningitis complicating medicinal leech therapy. Clin Infect Dis 2004; 38: e36-e37
• 9 Kilic M, Ak R. Orbital Cellulitis Due To Leech Therapy. Bull Emerg Trauma 2019; 7: 335-336
• 10 Lee YC, Chiu CJ. Ocular leech infestation. Clin Ophthalmol 2015; 9: 419-421
• 11 King LP, Libby C, Coats DK. et al. Presumed septic emboli following dental extraction. Graefes Arch Clin Exp Ophthalmol 1993; 231: 667-668
• 12 Nishimura Y, Hagiya H, Obika M. et al. Comparison of the Clinico-Microbiological Characteristics of Culture-Positive and Culture-Negative Septic Pulmonary Embolism: A 10-Year Retrospective Study. Pathogens 2020; 9: 995
• 13 Nannan Panday RS, Lammers EMJ, Alam N. et al. An overview of positive cultures and clinical outcomes in septic patients: a sub-analysis of the Prehospital Antibiotics Against Sepsis (PHANTASi) trial. Crit Care 2019; 23: 182