54 year old presents with blurred vision

Posted by - Posted on 04/16/2016 21:53:09 Retina and Uveitis


54 year old with NTG presents with blurred vision. Fundus exam revealed scattred hemorrhages in the superior temporal quadrant. What percentage of patients  with this condition develop iris neovascularization?  Is prophylactic laser treatment indicated in a patient with 6 DD of retina ischemia to prevent NVE?  

Diagnosis:  Branch Retinal Vein Occlusion

Approxiamtely 1% of patients with BRVO develop iris neovascularization. Prophylactic laser treatment is not indicated in a patient with 6 DD of retina ischemia to prevent NVE. The recommendation is to monitor teh patient for the development of NVE followed by laser. 

Fun facts

BVO presents with intraretinal hem, retinal edema and sometimes cotton wool spots in a sector of retina drained by the affected vein. 

BVO commonly occurs at AV crossing

Risk factors - Hypertension; Cardiovascular disease; increased body mass index at 20 years of age; H/O glaucoma

DM is NOT an independent risk factor

Decreased vision is secondary to macular ischemia, CME, ME with hard exudates, sub retinal fibrosis and ERM.

Argon laser- indiacted in patients with macular edema and decreased vision between 20/40-20/200

SCORE study: Intravitreal corticosteroids are equally effective as laser in reducing macular edema and improving vision by 3 lines.

BRVO study: Intravitreal injection of ranibizumab improved vision in > 50% of patients with macular edema.

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