History/Chief Complaint

  • 52 year old, moderately myopic Hispanic male presented with blurred vision in the right eye for one week. Several months earlier, a superior nasal (SN) branch vein occlusion OD was observed. About 22 years ago, a CRVO was diagnosed in the OS. The full work-up at the time was negative and VA slowly improved to 20/20 over 10 months.
  • Based upon a maternal family history of glaucoma, lOPs in the middle to high twenties, and a large cup/disc ratio with subtle field loss, primary open angle glaucoma (POAG) was diagnosed and treated 15 years earlier.

Clinical Findings

  • BCVA: OD 20/20 and OS 20/20
  • Fundus Exam: New inferior hemi-central retinal vein occlusion (or hemiretinal vein occlusion) OD in addition to the previous SN vein occlusion observed months earlier.
  • VF: Field loss (see page 9) which has not progressed for over a decade OU.
  • GDx: Retinal nerve fiber layer abnormalities OU (see page 10) that have progressed to a minor degree over the past five years.

OCT Image

  • Foveal pit or depression OD is not visualized due to macula hemorrhages. The photoreceptor integrity line, PIL (see page 13) is normal in the OS but poorly defined OD due to retinal hemorrhages.