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Central Retinal Artery Occlusion - 2 months old by history324 views77-year-old man was doing fine. His left eye was a little worse than the right eye, and then in the 2 months ago he had sudden severe vision loss in the right eye. Vision OD is 3/200; OS is 20/60. IOP: OD 30, OS 15.
OD: Vertical C/D ratio is 0.4. The macula is white from ischemia. The arteries are narrow.
Photos confirm clinical findings.
OCT SCAN: OCT scan of the right eye shows retinal thickening, consistent with macular edema associated with a central retinal artery occlusion. The left eye has severe inferior retinal thinning, consistent with an old hemicentral retinal artery occlusion in the left eye. The fovea in the left eye is a little bit thin but not too bad.

IMPRESSION: 1. CENTRAL RETINAL ARTERY OCCLUSION RIGHT EYE
2 OLD HEMICENTRAL RETINAL ARTERY OCCLUSION LEFT EYE
3 DIABETES WITHOUT RETINOPATHY
4 ELEVATED INTRAOCULAR PRESSURE RIGHT EYE STATUS POST INJECTION RIGHT EYE A WEEK AGO

DISCUSSION: I explained to the patient that the right eye unfortunately has had a central retinal artery and unfortunately we do not have anything to treat that. His vision will probably improve some over time. He needs to be watched though. It is possible he is developing rubeotic glaucoma, although it is probable the intraocular pressure is high from the injection last week. I asked him to restart the Alphagan, to stop the other two drops, and to return here in three weeks to make sure his pressure is more acceptable.

At this point, having lost almost all the retinal circulation in the right eye and half of the retinal circulation in the left eye, he only has half a retina in the left eye he is working off of. I told him it is very important he keep seeing you and anything that can be done to keep his blood pressure low and his cholesterol reasonable would be helpful to what remains of his retinal circulation.
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Branch Retinal Vein Occlusion with Macular Edema192 viewsCentral foveal thickness came to normal after laser and intravitreal Kenalog
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