1. History
  2. Exam
  3. Photos
  4. Diagnosis
  5. Teaching Points
  6. Comments

Case 16 Teaching Points

  • Occlusion of a retinal vein at the arteriovenous crossing
    • Artery and vein share a common adventitial sheath
    • Atherosclerotic arteriole compresses the vein
  • Usually ages 60-75 years
  • Associated with hypertension and atherosclerosis
  • Presents with hemorrhages, edema, cotton-wool spots, dilated/tortuous vein, most often involves the superotemporal quadrant
  • Most often resolves spontaneously but may leave persistent macula edema or neovascularization if area of perfusion is large enough
  • Grid laser photocoagulation and/or intravitreal triamcinolone injection may be considered after three months if vision is less than 20/40 secondary to the macular edema and not macular ischemia

References

Kaiser PK, Friedman NJ, Pineda R. The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology, 2nd ed, WB Saunders: Philadelphia, 2004.

Chern KC, Zegans ME. Ophthalmology Review Manual, Lippincott Williams & Wilkins: Philadelphia, 2000.

Yanoff M, Duker JS. Ophthalmology, 2nd ed, Mosby: St. Louis, 2004.

Last Modified: Friday, 27-Jun-2008 11:13:19 EDT