Unusual Manifestation of Central Retinal Vein Occlusion and Associated Open Angle Glaucoma

ABSTRACT

Central retinal vein occlusion(CRVO)is characterized by rapid, painless decrease in visual acuity, edema of the optic disc and retina, marked dilatation and tortuosity of the retinal veins, and extensive retinal hemorrhages in all quardrants.Many ocular and systemic conditions associated with CRVO include diabetes, hypertension, collagen vascular disorder, hyperviscosity syndrome and open-angle glaucoma.When no systemic vascular disease is present in younger patients, the prognosis is known to be good. We experienced a case of CRVO with cilioretinal artery occlusion and open-angle glaucoma in young woman with one month treatment with thrombolytic agents, beta-blocker and carbonic anhydrase inhibitors. CRVO was resolved however intraocular pressure could not be controlled. She underwent trabeculectomy and then developed prolonged hypotony and hypotony maculopathy. It is not clear how long an eye can tolerate hypotony maculopathy before the visual loss is irreversible, but return of good vision has been reported when the overfiltration was reversed within 6 months of the onset of the complication. Hypotony state was sustained more than 8 months but hypotony maculopathy was resolved with visual improvement.