Case presentation:
A 62-year-old man with a past medical history of type 2 diabetes
mellitus, hypertension and diabetic nephropathy under hemodialysis,
referred to the emergency department of Valiasr hospital, Tehran, Iran
on April, 29, 2021. He presented with shortness of breath and hypoxia.
He had two histories of surgery, coronary artery bypass grafting (CABG)
and cataract surgery for both eyes. On admission, his vital signs showed
a temperature of 37.3°C, heart rate of 100, respiratory rate of 24,
blood pressure of 117/63 mm Hg and pulse oximetry of 60%. Moreover,
crackle sounds were heard when he was breathing. Upon examination, he
was diagnosed with acute respiratory distress syndrome (ARDS), so he was
admitted to intensive care unit (ICU) and stayed there for 10 days. On
day 8 of hospitalization, the patient complained of a headache and pain
in the right eye followed by a more severe headache and edema in the
right eye the next day.
On day 10 of hospitalization, his health condition exacerbated. He had
vision loss on the right eye and proptosis in both eyes. In eye
examination chemosis, conjunctivitis and cherry red spot in the right
eye were seen, which represented central retinal artery occlusion
(CRAO).
He was transferred to ophthalmology center (Rasoul Akram hospital) for
endoscopic surgical debridement. Unfortunately, he expired on hospital
day 30.