66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatments monthly. The last treatment was six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30. IOP: OD 17. The right eye has 2+ nuclear sclerotic cataract.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There are optociliary shunt vessels on the optic nerve. There is 2+ cystoid macular edema. There are patchy retinal hemorrhages and dilated retinal veins.
OCT SCAN: The OCT scan shows recurrent macular edema.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: Shows temporal nonperfusion almost up to the center of the fovea.
IMPRESSION:
1. CENTRAL RETINAL VEIN OCCLUSION – RIGHT EYE
2. RESOLVED MACULAR EDEMA – RIGHT EYE
3. PERIPHERAL NONPERFUSION – RIGHT EYE
DISCUSSION: I explained to the patient with the recurrent macular edema, I think it is reasonable to restart Lucentis treatment, but also supplement laser to try to prevent recurrence again. I did a focal laser today trying to create a chorioretinal anastomosis. I asked her to return in a week for a Lucentis treatment and subsequent to that I will add a panretinal laser, especially the temporal periphery.
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 696 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.  
(1 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 621 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 430 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 492 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 445 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 605 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 436 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 417 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 407 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 424 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 460 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 495 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 483 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 482 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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Central Retinal Vein Occlusion Recurrent Edema 6 weeks after Lucentis - Nonperfusion Temporallyvu 531 fois66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatment six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30.
(0 votes)
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66-year-old woman has a central retinal vein occlusion in the right eye with macular edema. She had intravitreal Lucentis treatments monthly. The last treatment was six weeks ago and she has noticed over the last week or two her vision is declining.
VISUAL ACUITY: OD 20/70, OS 20/30. IOP: OD 17. The right eye has 2+ nuclear sclerotic cataract.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There are optociliary shunt vessels on the optic nerve. There is 2+ cystoid macular edema. There are patchy retinal hemorrhages and dilated retinal veins.
OCT SCAN: The OCT scan shows recurrent macular edema.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: Shows temporal nonperfusion almost up to the center of the fovea.
IMPRESSION:
1. CENTRAL RETINAL VEIN OCCLUSION – RIGHT EYE
2. RESOLVED MACULAR EDEMA – RIGHT EYE
3. PERIPHERAL NONPERFUSION – RIGHT EYE
DISCUSSION: I explained to the patient with the recurrent macular edema, I think it is reasonable to restart Lucentis treatment, but also supplement laser to try to prevent recurrence again. I did a focal laser today trying to create a chorioretinal anastomosis. I asked her to return in a week for a Lucentis treatment and subsequent to that I will add a panretinal laser, especially the temporal periphery.
