Oral contraceptive pills: A risk factor for retinal vascular occlusion in in-vitro fertilization patients
A female patient aged 38 years who was a case of primary infertility was recruited for her fourth consecutive IVF cycle. She was started on monophasic OCP on Day 2 of her periods. Tubal factor was the cause of infertility. Her three consecutive cycles of IVF had failed earlier prior to initiation of this fourth IVF cycle. At that time also, she was given monophasic OCP for down regulation of ovaries as well as to make the ovaries silent after the failure of cycle. After a few months of treatment, she complained of painless diminution of vision in right eye, which was not associated with any other complaint. On examination, her best corrected visual acuity was found to be 6/12 partial in right eye and 6/6 in left eye. The anterior segment findings were within normal limits. On fundus examination, the upper temporal vein was found to be dilated and congested, with cotton wool spots and dot and blot hemorrhages along the upper temporal branch of retinal vein. Associated macular edema was confirmed on optical coherence tomogram []. All the systemic and local causes investigated were within normal limits. It was diagnosed to be secondary to OCP. Patient was given an intra-vitreal injection of triamcinolone acetonide a steroid compound. The edema and hemorrhages resolved within 3 months and the visual acuity improved to 6/6 after 3 months.