This patient presented with 20/70 vision from an acute central retinal vein occlusion (CRVO) with mild macular edema.
The mild vision reduction and the well-perfused fluorescein angiogram support the diagnosis of a non-ischemic CRVO.
He is currently undergoing intravitreal injections for the macular edema.
Learning Points:
Patients with CRVO are at risk of vision loss due to macular edema or anterior segment neovascularization. Macular edema is common in both non-ischemic and ischemic occlusions, although rubeosis is found almost exclusively with ischemic occlusions.
Iris neovascularization with neovascular glaucoma develops in about two-thirds of patients with untreated ischemic occlusions. Rubeosis is initially treated with an anti-VEGF injection, followed by aggressive, complete panretinal photocoagulation.
Some patients will need a glaucoma tube or a cyclodestructive procedure if the IOP remains too high.
