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November 1993

Combined Obstruction of the Central Retinal Artery and Vein Associated With Meningeal Carcinomatosis

Arch Ophthalmol. 1993;111(11):1467-1468. doi:10.1001/archopht.1993.01090110025011

Meningeal carcinomatosis is a diffuse infiltration of the meninges by metastatic tumor cells. The subsequent low-grade meningitis can cause optic neuropathy and visual loss. We describe herein a patient with breast cancer and meningeal carcinomatosis who did develop an optic neuropathy in one eye but who experienced abrupt visual loss in the contralateral eye as a result of a combined central retinal artery occlusion and central retinal vein occlusion (combined CRAO/CRVO).

Report of a Case.  A 64-year-old black woman experienced sudden loss of vision in her right eye. One year earlier, poorly differentiated adenocarcinoma of the breast was discovered. In March 1992, cerebrospinal fluid analysis showed cells consistent with metastatic breast cancer. Intrathecal methotrexate sodium treatment (15 mg twice per week) was begun. Three months later, the patient experienced sudden visual loss in her right eye.On examination, visual acuity was no light perception in the right eye and 20/50