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49-year-old woman has central retinal vein occlusion right eye with fluctuating vision and then recently her vision declined and she developed macular edema. I was worried about her angle and you were kind enough to do a peripheral iridotomy and I am dilating her today. Her vision is still poor. VISUAL ACUITY: OD 20/100. IOP: OD 20. There is a peripheral iridotomy, lens is clear, there is no rubeosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is 2+ optic nerve edema, 3+ cystoid macular edema. The retinal veins are dilated in all 4 quadrants. The photos confirm clinical findings. Fluorescein angiogram shows some substantial delay in the venous circulation time with no non-profusion. IMPRESSION: 1. PERFUSED CENTRAL RETINAL VEIN OCCLUSION RIGHT EYE. 2. MACULAR EDEMA IN THE RIGHT EYE. DISCUSSION: I explained to the patient that with intravitreal Kenalog there is about an 80% chance of drying up the macula and improving the vision. There is a risk of cataract and glaucoma and a very low risk of infection. I injected the eye today without difficulty with the Kenalog.

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55 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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47 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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39 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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43 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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42 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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53 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2055555
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40 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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32 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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35 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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49 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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35 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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41 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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46 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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26 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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44 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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61 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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50 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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36 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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50 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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56 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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38 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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54 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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85 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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67 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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94 views49-year-old woman has central retinal vein occlusion right eye with fluctuating vision for a few month now with OD 20/100. IOP: OD 2000000
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49-year-old woman has central retinal vein occlusion right eye with fluctuating vision and then recently her vision declined and she developed macular edema. I was worried about her angle and you were kind enough to do a peripheral iridotomy and I am dilating her today. Her vision is still poor. VISUAL ACUITY: OD 20/100. IOP: OD 20. There is a peripheral iridotomy, lens is clear, there is no rubeosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is 2+ optic nerve edema, 3+ cystoid macular edema. The retinal veins are dilated in all 4 quadrants. The photos confirm clinical findings. Fluorescein angiogram shows some substantial delay in the venous circulation time with no non-profusion. IMPRESSION: 1. PERFUSED CENTRAL RETINAL VEIN OCCLUSION RIGHT EYE. 2. MACULAR EDEMA IN THE RIGHT EYE. DISCUSSION: I explained to the patient that with intravitreal Kenalog there is about an 80% chance of drying up the macula and improving the vision. There is a risk of cataract and glaucoma and a very low risk of infection. I injected the eye today without difficulty with the Kenalog.