CRVO

CASE HISTORY
• A 69 year old male patient presented to us with
complain of Right eye diminution of vision since
1 year with sudden painless worsening since 1
month.
• Patient had no ocular complains in left eye.

• Negative history
• No history of pain, congestion, floaters, flashes.
• Past history:
• No history of glasses present
• No history of trauma, foreign body.
• History of right eye cataract surgery 11 years back.

• Systemic illness:
• Patient is a known case of diabetes mellitus and hypertension
since 10 years on regular medication.
• Patient is using blood thinners since 10 years.

• Family history : Not significant.

 GENERAL EXAMINATION

• Patient is conscious, cooperative and well

oriented to time place and person.
• Blood pressure: 160/90 mmhg
 OCULAR EXAMINATION
EXAMINATION RIGHT EYE LEFT EYE
BCVA 6/18 with -1D at 90 degree 6/6 plano
Lid/ Adnexa Normal Normal
Conjunctiva Normal Normal
Cornea/ sclera Normal Normal
Anterior chamber Normal depth Normal depth
Iris/ Pupil N/S/S/Reacting to light N/S/S/Reacting to light
Lens Pseudophakia Clear
Extraocular movements Full Full
Digital tension Normal Normal
IOP(NCT) 18mmhg 16mmhg
 Fundus examination
• Right eye:
• Media: Clear
• Disc: 0.3 CDR with neovascularization at disc present.
• Blood vessels: Tortuosity and dilatation of all
branches of central retinal vein.
• Background: Dot blot and flame shaped
haemorrhages in all 4 quadrants. Cotton wool spots
also present
• Macula : Cystoid macular edema present.
Right eye fundus photo
• Left eye:
• Media: Clear
• Disc: 0.3 CDR
• Blood vessels: Arterial attenuation with mild
tortuosity present.
• Background: Few flame shaped haemorrhages
with hard exudates present
• Macula : Foveal reflex dull
Left eye fundus photo
PSOCT
• PSOCT FINDINGS:
• Cystoid Macular edema with central foveal
thickness of 685 micrometer.
 PROVISIONAL DIAGNOSIS
• RE: Non ischemic CENTRAL RETINAL VEIN
OCCLUSION WITH CYSTOID MACULAR EDEMA.
• LE: Grade 2 Hypertensive retinopathy.
 PLAN OF MANAGEMENT
• Investigations:
• CBC
• RFT and LFT
• Lipid profile
• Coagulation profile
• Serum homocysteine
• Carotid artery doppler
• Treatment:
• Control of systemic illness
• Cardiac and physician reference as patient is
using blood thinners.

• Right eye intravitreal injection Anti-VEGF

(Ranibizumab)
THANKYOU