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Central retinal vein occlusion

Color retinography showing CRVO with papilledema and intraretinal hemorrhages, and the presence of the lower dexamethasone device.

Description

Retinal vein occlusion (RVO) is the second most common cause of vision loss due to retinal vascular disease after diabetic retinopathy. Branch vein obstruction (BRVO) is more common than central retinal vein obstruction (CRVO). CRVO is due to an occlusion of this vein at the level of the optic nerve. Thrombus formation is the primary pathophysiological factor, and endothelial proliferation and inflammatory reaction are secondary effects. Risk factors that have been linked to CRVO are open-angle glaucoma and factors such as high blood pressure or diabetes, although in patients under 60 years of age it is necessary to rule out other causes of hypercoagulability (entities related to blood hyperviscosity, thrombophilia or others). Intravitreal dexamethasone implant or antiangiogenic drugs represent the treatment of choice for the treatment of macular edema.

Comments

Indication

A 68-year-old woman presented with central visual loss in her left eye that had lasted for several days, with a corrected visual acuity of 0.2 (decimal scale, Snellen). Funduscopic examination revealed CRVO with papilledema, the presence of dense intraretinal hemorrhages in the 4 quadrants, and macular edema (ME). For the treatment of ME, an intravitreal dexamethasone injection was performed, achieving complete reabsorption of the fluid.