This 61YO male patient presented with a non-ischemic central retinal vein occlusion (CRVO), 20/30 vision, and macular edema.
With ongoing Eylea treat-extend protocol, the hemorrhages and macular edema completely resolved. Prominent optic nerve collaterals were noted.
Learning Points:
Before the introduction of intravitreal injections in the early 2000s, there were essentially no treatments for CRVO-related macular edema.
Anti-VEGF injections are now generally the initial treatment of choice, with about 50-60% of eyes gaining at least 3 lines of vision. Intravitreal steroids, usually Ozurdex, are more often used as secondary treatment.
Macular grid laser photocoagulation is not performed because it has been shown to confer no visual benefit in the Central Vein Occlusion Study Group (see Ophthalmology 1995;102;1425-1433).
