Central Retinal-Vein Occlusion Five Days after a Marathon

To the Editor: Central retinal-vein occlusion, a condition that threatens vision, produces a characteristic appearance in the fundus, including disk edema, venous engorgement, retinal edema, retinal hemorrhages, and some degree of retinal ischemia. Known predisposing factors include elevated intraocular pressure, hyperviscosity syndromes, hypertension, diabetes mellitus, generalized arteriosclerosis, and coagulation abnormalities. Occasionally, this condition (sometimes called papillophlebitis) may develop in young, apparently healthy patients, and systemic evaluation of these patients is frequently unrevealing. We recently examined a 34-year-old physician who had central retinal-vein occlusion after completing a marathon (26.2 miles [42 km]). He had trained for the race for six months.