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Employee’s State Insurance Model Hospital (Ministry of Labour & Employment, Govt. of India)
Lane No.02, SIDCO Industrial Complex,
Bari Brahmana, Jammu(J&K)
(ISO 9001:2000 Certified)
Phone No. 01923-221105, 01923-220302 Fax No. 01923-221105
E-mail: [email protected]
Intravitreal injection of Anti VEGF’s is an important treatment in management of Macular Edema
70 years old male patient, presented to ophthalmology OPD of ESIC Jammu with
sudden painless marked diminution of vision left eye of 1 day duration. The patient
was a known case of diabetes mellitus on oral hypoglycemic agents since past 6
years. Also there was history of hypertension for past 9 months but he was not
taking any medication for it. There was no history of trauma or any bleeding
diathesis. He was a non vegetarian, non smoker and a non alcoholic with a positive
family history of hypertension and diabetes mellitus.
General physical examination showed, patient was mildly obese with a pulse rate
of 90/minute and BP of 190/110 mm of Hg. Best corrected visual acuity (BCVA)
was hand movements (HM) close to face in left eye and 6/9 in right eye.
Ocular examination revealed normal anterior segment, posterior segment
evaluation after dilatation revealed few retinal hemorrhages around disc and in
region of infero temporal vessels in left eye. There was also accompanying
macular and disc edema. Intraocular pressure (IOP) was 20 mm of Hg in both eyes.
A provisional diagnosis of infero-temporal BRVO was made.
Hematological investigations showed Hb of 11.8 g%, blood sugar fasting was 105
mg/do with HbA1c of 6.8%, BT, CT, serum homocysteine and renal function tests
were within normal limits.
Patient was immediately sent to physician where he was put on anti hypertensive
medications and advised dietary restriction for control of BP.
Fundus fluoroscein angiography (FFA) was done and block at level of infero-
temporal vein was seen. Moreover OCT scan showed central macular thickness of
450 microns was documented. A diagnosis of infero-temporal BRVO with macular
edema left eye was made.
Patient was worked up for 3 injections of Ranibizumab in left eye after an interval
of 1 month each. BCVA after 1st injection was 3/60, 2nd injection was 6/60 and
after 3rd injection was 6/36 in left eye. OCT images also showed decrease in
macular thickness from 450 microns to 230 microns with improvements in fundus
picture.
Employee’s State Insurance Model Hospital (Ministry of Labour & Employment, Govt. of India)
Lane No.02, SIDCO Industrial Complex,
Bari Brahmana, Jammu(J&K)
(ISO 9001:2000 Certified)
Phone No. 01923-221105, 01923-220302 Fax No. 01923-221105
E-mail: [email protected]
Employee’s State Insurance Model Hospital (Ministry of Labour & Employment, Govt. of India)
Lane No.02, SIDCO Industrial Complex,
Bari Brahmana, Jammu(J&K)
(ISO 9001:2000 Certified)
Phone No. 01923-221105, 01923-220302 Fax No. 01923-221105
E-mail: [email protected]
