Chorioretinal Anastomosis Central Retinal Vein Occlusion
|
|
84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. Her vision seems to be about the same. She is bothered by floaters in her left eye.
VISUAL ACUITY: Vision OD is 20/160, OS is 7/200. IOP: OD 13, OS 15. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is concentric geographic atrophy in the fovea, now a disc
diameter across.
OS: Vertical C/D ratio is 0.2. There is concentric geographic atrophy of the fovea. There is also chorioretinal anastomosis and laser scar superior and inferior to the optic nerve and inferotemporal
to the macula.
OCT SCAN: The OCT scan shows no intraretinal or subretinal fluid.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows some flow through the anastomoses in the left eye.
There is also reasonably good circulation through the central retinal artery. Both eyes have hyperfluorescence centrally corresponding to geographic atrophy with no evidence of any neovascularization.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. CONCENTRIC GEOGRAPHIC ATROPHY – BOTH EYES
3. CENTRAL RETINAL VEIN OCCLUSION WITH SUCCESSFUL CHORIORETINAL ANASTOMOSES – LEFT EYE
DISCUSSION: I explained to the patient that the maculae unfortunately are drying and becoming thinner and that is making her visual function worse. The central retinal vein occlusion in the left eye, if anything, looks a little better. I told her the floaters in the left eye also appear to have largely subsided and I do not think surgery would particularly help her.
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 810 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 634 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 786 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 585 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 553 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 666 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 441 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 571 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 587 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 586 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 530 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
Central Retinal Vein Occlusion and Laser Induced Chorioretinal Anastomosisvu 515 fois84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. VISUAL ACUITY: Vision OD is 20/160, OS is 7/200
(0 votes)
|
|
|
|
84-year-old woman has age-related macular degeneration in both eyes with foveal atrophy. She also has a central retinal vein occlusion
in the left eye for which she had intravitreal Kenalog and finally chorioretinal anastomosis laser a year
ago. Her vision seems to be about the same. She is bothered by floaters in her left eye.
VISUAL ACUITY: Vision OD is 20/160, OS is 7/200. IOP: OD 13, OS 15. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is concentric geographic atrophy in the fovea, now a disc
diameter across.
OS: Vertical C/D ratio is 0.2. There is concentric geographic atrophy of the fovea. There is also chorioretinal anastomosis and laser scar superior and inferior to the optic nerve and inferotemporal
to the macula.
OCT SCAN: The OCT scan shows no intraretinal or subretinal fluid.
PHOTOGRAPHS: Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: FA shows some flow through the anastomoses in the left eye.
There is also reasonably good circulation through the central retinal artery. Both eyes have hyperfluorescence centrally corresponding to geographic atrophy with no evidence of any neovascularization.
IMPRESSION:
1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES
2. CONCENTRIC GEOGRAPHIC ATROPHY – BOTH EYES
3. CENTRAL RETINAL VEIN OCCLUSION WITH SUCCESSFUL CHORIORETINAL ANASTOMOSES – LEFT EYE
DISCUSSION: I explained to the patient that the maculae unfortunately are drying and becoming thinner and that is making her visual function worse. The central retinal vein occlusion in the left eye, if anything, looks a little better. I told her the floaters in the left eye also appear to have largely subsided and I do not think surgery would particularly help her.
