Neovascular Glaucoma Due to Branch Retinal Vein Occlusion Combined with Branch Retinal Artery Occlusion

Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) rarely cause neovascular glaucoma (NVG). A 58-year-old woman with hypertension and type 2 diabetic mellitus complained of progressive visual loss in her right eye for the previous 3 months. At initial examination, visual acuity was 20 / 63 in the right eye. Angle neovascularization was observed and the intraocular pressure (IOP) was 30 mmHg in her right eye. Fundus examination and fluorescein angiography showed BRAO combined with BRVO. We immediately injected intravitreal and intracameral bevacizumab in her right eye. The next day, we performed scatter photocoagulation in the nonperfusion area. One month later, visual acuity was 20 / 20 in her right eye and the IOP was 17 mmHg with one topical antiglaucoma agent. The neovascularization had regressed completely. We report a case of unilateral NVG which was caused by BRAO with concomitant BRVO and advise close ophthalmic examination of the iris and angle in BRVO with BRAO.

The Changes in Central Macular Thickness after Cataract Surgery in Patients with Diabetic Retinopathy

PURPOSE: To evaluate the changes in central macular thickness (CMT) and incidence of macular edema (ME) after cataract surgery in diabetic patients compared with non-diabetic patients using optical coherence tomography (OCT). METHODS: The records of 138 diabetic patients and 34 non-diabetic patients who underwent cataract surgery were retrospectively reviewed. The diabetic group was divided into 5 groups according to severity of diabetic retinopathy. The diabetic group was also divided into 2 groups depending on prior panretinal photocoagulation history. The changes in CMT were examined using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery in diabetic and non-diabetic patients. RESULTS: The incidence of ME in the diabetic group and non-diabetic group was 19.6% and 2.9% respectively. The increased amount of CMT (DeltaCMT) was significantly greater in the diabetic group compared with the non-diabetic group during the observation period (p < 0.05). The DeltaCMT of eyes without a history of panretinal photocoagulation was statistically greater compared to the eyes with a history of panretinal photocoagulation at 1-, 2- and 6-months after cataract surgery (p = 0.005, 0.002, 0.008, respectively). CONCLUSIONS: The DeltaCMT and incidence of ME were significantly greater in the diabetic group compared with the non-diabetic group. Additionally, the incidence of ME was significantly greater depending on severity of diabetic retinopathy in the diabetic group.

A Case of Acute Retinal Necrosis Following Herpes Simplex Virus (HSV) Encephalitis

PURPOSE: To report a case of unilateral acute retinal necrosis (ARN) following herpes simplex virus (HSV) encephalitis. CASE SUMMARY: A 19-year-old man previously diagnosed with HSV encephalitis presented with a headache and visual loss in his left eye. On the initial visit, slit-lamp examination showed conjunctival injection and inflammatory cells (3+) in the anterior chamber of the left eye. Funduscopic examination showed optic disc swelling, multiple yellow-whitish spots in the peripheral retina and retinal vascular sheathing. After the patient was diagnosed with ARN, intravenous acyclovir (1,500 mg/m2/day) was administered. Because retinal detachment and multiple retinal breaks were found during the treatment period, the authors performed barrier laser treatment in the peripheral retina. At that time, no retinal necrosis was observed in the patient's right eye. The retinal lesions regressed, and no new retinal lesion was observed in the left eye, during the follow-up period. CONCLUSIONS: We report a case of ARN in a patient with HSV encephalitis. Ophthamologist should perform a thorough ophthalmic examination in a patient diagnosed with HSV encephalitis.