68-year-old man was seen in our office on 12/04/07. He has noticed change in his vision over the last six weeks. He says his vision is foggy. He feels if anything, over the last 2-3 weeks the vision might be improving some. You saw a problem with the retina and suggested he come in here for an evaluation. He has a history of high blood pressure, high cholesterol and heart disease.
VISUAL ACUITY: Vision OD 20/50. OS: 20/25. IOP: OS 15, OS 13.
SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. There is no rubeosis in the right eye.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.3. There is 1+ optic nerve edema. There is no posterior vitreous separation. There is 2+ cystoid macular edema. The retinal veins are dilated in all four quadrants and retinal hemorrhages in all four quadrants.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There are 1+ AV crossing changes.
OCT scan shows macular edema in the right eye. The left eye has a normal foveal contour. The fluorescein angiogram shows moderately delayed venous circulation of the right eye. There is good profusion throughout the periphery. There is macular edema in the late frames in the right eye. The left eye has AV crossing changes.
Gonioscopy shows no rubeosis in the angle.
IMPRESSION:
1. HYPERTENSIVE RETINOPATHY - BOTH EYES
2. PROFUSE CENTRAL RETINAL VEIN OCCLUSION - RIGHT EYE
3. CYSTOID MACULAR EDEMA - RIGHT EYE
DISCUSSION: I explained to the patient that he does have a central retinal vein occlusion in the right eye and macular edema. The macular edema generally responds to Avastin, but given that he feels his vision might be improving some, I suggested we leave the eye alone for now. I asked him to return here for check in 6 weeks; sooner should he notice any problem.
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 809 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 832 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 712 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 623 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 759 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 587 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 626 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 624 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
(0 votes)
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 583 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 640 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
(0 votes)
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 587 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
(0 votes)
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Central Retinal Vein Occlusion and Cystoid Macular Edema - Acute - Vision 20/50 611 views68-year-old man six weeks of vision loss right eye from CRVO and CME, vision right eye 20/50
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68-year-old man was seen in our office on 12/04/07. He has noticed change in his vision over the last six weeks. He says his vision is foggy. He feels if anything, over the last 2-3 weeks the vision might be improving some. You saw a problem with the retina and suggested he come in here for an evaluation. He has a history of high blood pressure, high cholesterol and heart disease.
VISUAL ACUITY: Vision OD 20/50. OS: 20/25. IOP: OS 15, OS 13.
SLIT LAMP EXAM: There is 1+ nuclear sclerosis in both eyes. There is no rubeosis in the right eye.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.3. There is 1+ optic nerve edema. There is no posterior vitreous separation. There is 2+ cystoid macular edema. The retinal veins are dilated in all four quadrants and retinal hemorrhages in all four quadrants.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There are 1+ AV crossing changes.
OCT scan shows macular edema in the right eye. The left eye has a normal foveal contour. The fluorescein angiogram shows moderately delayed venous circulation of the right eye. There is good profusion throughout the periphery. There is macular edema in the late frames in the right eye. The left eye has AV crossing changes.
Gonioscopy shows no rubeosis in the angle.
IMPRESSION:
1. HYPERTENSIVE RETINOPATHY - BOTH EYES
2. PROFUSE CENTRAL RETINAL VEIN OCCLUSION - RIGHT EYE
3. CYSTOID MACULAR EDEMA - RIGHT EYE
DISCUSSION: I explained to the patient that he does have a central retinal vein occlusion in the right eye and macular edema. The macular edema generally responds to Avastin, but given that he feels his vision might be improving some, I suggested we leave the eye alone for now. I asked him to return here for check in 6 weeks; sooner should he notice any problem.
