Female, age 67, caucasian, history of Ischaemic CRVO (centra | Figure 1

FabrizioSinisi
Ophthalmology Resident

Patient Overview:
Female, age 67, Caucasian, history of Ischaemic CRVO (central retinal vein occlusion) treated with intravitreal dexamethasone implant.

Two months later she developed a #Neovascular Glaucoma.
In the following pictures, a typical feature is shown:
Neovascularization at the pupillary margin.
Subtle vessels start to grow radially from the pupillary margin towards the angle; an early detection of such sign could substantially improve the prognosis.

New vessels are more likely to be visualised on light-coloured irises; a red-free filter could be helpful in the detection of abnormal vessels.

Treatment:

• Reduce elevated IOP avoiding miotics and prostaglandin derivatives.
• Atropine 1% to resist posterior synechiae and PAS formation.
• Panretinal and gonio photocoagulation may induce regression of neovascularization with Anti VEGF intravitreal injections as supportive therapy.