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67-year-old woman has vision loss in the left eye. She said she saw a black spot in that eye in 2008. She has had laser in 2010. She is diabetic for ten years. She recently has been visiting her doctors, because she didn’t have insurance until recently. Now that she is on Medicare she has been trying to do what she can to improve her situation. She does take aspirin. VISUAL ACUITY: OD 20/32, OS 3/200. IOP: OD 16, OS 13. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation and rare macular drusen. OS: Vertical C/D ratio is 0.1. There is a partial posterior vitreous separation. There is vitreomacular traction. There is retinal hemorrhage and pan retinal laser. Photos confirm clinical findings. SPECTRALIS-SD-OCT SCAN: The OCT scan shows an average central foveal thickness in the right eye of 259 microns and the left eye has 800 microns. (NOTE: Retinal thickness measured with Spectralis OCT is approximately 70 μm greater than that measured with Stratus OCT. This increased measurement corresponds to the inclusion of the outer segment-RPE-Bruch's membrane complex by Spectralis OCT.) IMPRESSION: 1. CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE 2. TRACTIONAL RETINAL DETACHMENT – LEFT EYE 3. AGE-RELATED MACULAR DEGENERATION – RIGHT EYE DISCUSSION: I explained to the patient she does have a tractional retinal detachment in the right eye associated with a central retinal vein occlusion. Unfortunately, given the duration of the pathology in the left eye, the chance of any intervention helping improve her visual function is extremely low and the risk would be very high and I don’t believe the risks would be worth the potential benefit.

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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)215 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)169 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)151 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)168 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)207 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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Central Retinal Vein Occlusion and Tractional Retinal Detachment for 3 Years (Patient is Diabetic)189 views67-year-old woman has severe vision loss in the left eye for 3 years OD 20/32, OS 3/20000000
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67-year-old woman has vision loss in the left eye. She said she saw a black spot in that eye in 2008. She has had laser in 2010. She is diabetic for ten years. She recently has been visiting her doctors, because she didn’t have insurance until recently. Now that she is on Medicare she has been trying to do what she can to improve her situation. She does take aspirin. VISUAL ACUITY: OD 20/32, OS 3/200. IOP: OD 16, OS 13. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation and rare macular drusen. OS: Vertical C/D ratio is 0.1. There is a partial posterior vitreous separation. There is vitreomacular traction. There is retinal hemorrhage and pan retinal laser. Photos confirm clinical findings. SPECTRALIS-SD-OCT SCAN: The OCT scan shows an average central foveal thickness in the right eye of 259 microns and the left eye has 800 microns. (NOTE: Retinal thickness measured with Spectralis OCT is approximately 70 μm greater than that measured with Stratus OCT. This increased measurement corresponds to the inclusion of the outer segment-RPE-Bruch's membrane complex by Spectralis OCT.) IMPRESSION: 1. CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE 2. TRACTIONAL RETINAL DETACHMENT – LEFT EYE 3. AGE-RELATED MACULAR DEGENERATION – RIGHT EYE DISCUSSION: I explained to the patient she does have a tractional retinal detachment in the right eye associated with a central retinal vein occlusion. Unfortunately, given the duration of the pathology in the left eye, the chance of any intervention helping improve her visual function is extremely low and the risk would be very high and I don’t believe the risks would be worth the potential benefit.