This 72YO male presented with marked macular edema and 20/150 vision from a nonischemic central retinal vein occlusion (CRVO).
Four weeks later, following a single Lucentis injection, vision improved to 20/70, and the edema almost completely resolved. Although most patients respond favorably to anti-VEGF therapy, our patient’s dramatic, rapid improvement following a single injection is quite unusual.
CRVO macular edema usually requires ongoing injections, and we are currently following a treat-and-extend protocol to maintain this improvement while minimizing the treatment burden.
Learning Points:
Prior to the introduction of intravitreal injections in the early 2000s, there were essentially no treatments for CRVO-related macular edema. Anti-VEGF injections in general are now the initial treatment of choice, followed by intravitreal steroids (usually Ozurdex).
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).
