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Intira Sukpen, Xiangbin Kong, Jay M Stewart; Presumed Central Retinal Vein Occlusion with Cystoid Macular Edema in Patients with Advanced Glaucoma: A Case Series. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4296. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the clinical presentation in a case series of six patients with advanced glaucoma that developed presumed central retinal vein occlusion (CRVO) with cystoid macular edema (CME) and the absence of retinal hemorrhages.
Retrospective review of medical records of six patients with advanced glaucoma who developed presumed CRVO with CME. All six eyes of six patients were investigated with comprehensive ophthalmic examinations and were treated by monthly intravitreal anti-VEGF monotherapy. Responsiveness of anti-VEGF therapy was evaluated with improvement of visual acuity (VA) and anatomical resolution of CME on SD-OCT images.
All six patients had advanced glaucoma with well-controlled intraocular pressure. Each presented with newly decreased VA at a follow-up visit with their glaucoma specialist. Fundus findings were manifested by unremarkable vessel caliber, and an absence of retinal hemorrhages but the presence of mild retinal vessel tortuosity in some cases. Presumed CRVO with CME was diagnosed with FFA and SD-OCT. All six eyes showed good response to monthly intravitreal anti-VEGF therapy with improvement in VA and significant anatomical resolution of CME on SD-OCT.
This report describes a novel clinical picture consisting of presumed CRVO in the setting of advanced glaucoma, with CME but lacking other classic signs of CRVO. The results suggest that, as in typical CRVO, intravitreal anti-VEGF therapy may be useful and well-tolerated as a medical therapeutic option in these cases.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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