Late retinal neovascularization after central retinal vein occlusion: a case report and literature review.

ABSTRACT

PURPOSE: To present the case of a 59-year-old man with central retinal vein occlusion with limited retinal ischemia who developed retinal neovascularization over a year after initial presentation. METHODS: Retrospective case report. RESULTS: On initial presentation, the patient had counting fingers vision in the affected eye and significant macular edema. After 4 intravitreal ranibizumab injections, his vision improved to 20/30. An intravenous fluorescein angiography performed at presentation and at a 4-month follow-up revealed limited retinal ischemia and no neovascularization. Over a year after his initial presentation, the patient returned with visual symptoms and was found to have subhyaloid hemorrhage and areas of retinal neovascularization. CONCLUSION: Anterior and posterior segment neovascularization after central retinal vein occlusion has traditionally been thought to occur within a few months of the inciting event. However, the use of antivascular endothelial growth factor agents may alter the angiogenic processes within an eye after central retinal vein occlusion, potentially delaying the onset of neovascularization. This suggests the need for enhanced monitoring in this patient population.