Posted by firstname.lastname@example.org - 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.
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.