35-year-old man was seen in the office on January 6, 2010.
He has had hazy vision in his left eye for about the last three days. He has had no surgery and he has no history
of surgery. He has not had to his knowledge had any problems with any clotting disorders or bleeding disorders.
VISUAL ACUITY: OD 20/20, OS 20/30. IOP: OD 12, OS 14.
SLIT EXAMINATION: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 03. There is an inferior hemi central retinal vein occlusion. There is 2+ macular edema, mostly on the inferior edge of the macula. There are patchy retinal hemorrhages. The inferior retinal veins are dilated. The superior retinal veins look normal. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows delayed filling of the inferior branch of the central retinal vein starting within the border of the optic nerve with fluorescein leakage into the fovea in the late frames. There is patchy hypofluorescence corresponding to the hemorrhages, which are minimal.
IMPRESSION:
1. INFERIOR HEMI CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE
2. MACULAR EDEMA - LEFT EYE
DISCUSSION: I explained to the patient he does have a retinal vein occlusion in the left eye. The odds are excellent that this will heal itself. About 90% of people with retinal vein occlusions, who begin with good vision, maintain good vision. He does need to be followed though. I asked him to return here for a check in six weeks or sooner should he notice a problem and see you back regularly.
Because he is so young, it would be prudent to obtain a blood test on him to screen him for possible coagulopathies and I will send a note to his medical doctor to that affect.
NOTE: patient never followed up with medical doctor for testing or with us until he lost vision from a vitreous hemorrhage 8 months later. He is now being treated for that (November 2010)
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man847 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man724 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man791 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man530 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man502 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man449 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man475 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man509 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man558 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man482 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
Hemi Central Retinal Vein Occlusion 35 year old non-compliant man537 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/30
(0 votes)
|
|
|
|
|
35-year-old man was seen in the office on January 6, 2010.
He has had hazy vision in his left eye for about the last three days. He has had no surgery and he has no history
of surgery. He has not had to his knowledge had any problems with any clotting disorders or bleeding disorders.
VISUAL ACUITY: OD 20/20, OS 20/30. IOP: OD 12, OS 14.
SLIT EXAMINATION: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 03. There is an inferior hemi central retinal vein occlusion. There is 2+ macular edema, mostly on the inferior edge of the macula. There are patchy retinal hemorrhages. The inferior retinal veins are dilated. The superior retinal veins look normal. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows delayed filling of the inferior branch of the central retinal vein starting within the border of the optic nerve with fluorescein leakage into the fovea in the late frames. There is patchy hypofluorescence corresponding to the hemorrhages, which are minimal.
IMPRESSION:
1. INFERIOR HEMI CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE
2. MACULAR EDEMA - LEFT EYE
DISCUSSION: I explained to the patient he does have a retinal vein occlusion in the left eye. The odds are excellent that this will heal itself. About 90% of people with retinal vein occlusions, who begin with good vision, maintain good vision. He does need to be followed though. I asked him to return here for a check in six weeks or sooner should he notice a problem and see you back regularly.
Because he is so young, it would be prudent to obtain a blood test on him to screen him for possible coagulopathies and I will send a note to his medical doctor to that affect.
NOTE: patient never followed up with medical doctor for testing or with us until he lost vision from a vitreous hemorrhage 8 months later. He is now being treated for that (November 2010)
