OCT Tip 162 was originally published on January 28th, 2020.
This person had blurred vision. Why?
Analysis
In this image there is increased hyperreflectivity of the ganglion cell and inner plexiform layer (IPL). There is central thickening and hyporeflectivity located at the junction of the outer plexiform (OPL) and outer nuclear layer (ONL). Subretinal fluid (SRF) is present. At the time, this patient was diagnosed with a central retinal vein occlusion. She was treated with intravitreal injection with an anti-VEGF agent.
Shortly after her third injection, she presented with more pronounced blurred vision. At that time cloudy swelling was present (video); her OCT showed the presence of a middle limiting membrane (video).
The patient was diagnosed with a combined central retinal artery/vein occlusion.
In this tip's accompanying 18 min. video, Dr. Sharma takes you through additional diagnostic imagery as well as:
- How to identify CME on OCT and angiography
- The systemic causes of combined artery/vein occlusions (including a type of blood neoplasm)
- The deep capillary plexus changes seen on OCTA that help make the diagnosis of vein occlusion
OCT Tip
In any patient with a vein occlusion, always consider the possibility of a combined artery occlusion.
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