A 49-year-old female reporting one day of vision loss OD presented to our retina service on 1/14/2011 seeking treatment and a second opinion. The day before, at a different institution, she had been diagnosed with CRVO and advised that one month of observation was the best course of action.
Fundus photography and fluorescein angiography showed CRVO OD with no neovascularization (Figure 1). OCT was unable to accurately measure retinal thickness due to severe thickening. Thickness was approximately 1,200 microns (Figure 2). Visual acuity was 20/400. Because of the patient’s young age, we ordered a hypercoagulability work-up, which was positive for Protein S deficiency.
On the day the patient presented, we inserted dexamethasone intravitreal implant 0.7 mg (Ozurdex) OD. Three weeks later, vision improved to 20/30 and we performed grid laser OD (Figure 3). For the next 3 months, the patient did not require additional treatment. Three months after Ozurdex implantation and grid laser treatment (Figures 4 and 5), her visual acuity was 20/30 and her IOP was 15 mmHg. One year follow-up revealed that no further treatments were necessary and her vision was stable at 20/30.
— Case provided by Seenu M. Hariprasad, MD