|Year : 1971 | Volume
| Issue : 4 | Page : 183-184
Developmental glaucoma and branch vein occlusion in thee retina
DK Sen, GC Sood, R Dewan
Department of Ophthalmology, Maulana Azad Medical College, New Delhi, India
D K Sen
Department of Ophthalmology, Maulana Azad Medical College, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sen D K, Sood G C, Dewan R. Developmental glaucoma and branch vein occlusion in thee retina. Indian J Ophthalmol 1971;19:183-4
|How to cite this URL:|
Sen D K, Sood G C, Dewan R. Developmental glaucoma and branch vein occlusion in thee retina. Indian J Ophthalmol [serial online] 1971 [cited 2020 May 28];19:183-4. Available from: http://www.ijo.in/text.asp?1971/19/4/183/34968
The relationship between preexisting chronic simple glaucoma and the subsequent development of retinal vein occlusion has received emphasis in recent years. It has been observed that patient with chronic simple glaucoma more often develop retinal vein occlusion than normotensive in dividuals. Bertelsen noted a 43% incidence of simple glaucoma in his series of vein occlusion patients. Dryden examined clinically 26 patients with venous occlusion, 7 of whom had been seen prior to the occlusion and of whom 5 had bilateral simple glaucoma; in the remaining 19 patients first seen after the occlusion, 13 were found with simple glaucoma in the contra lateral eye. However, in all the :cases there was occlusion of the central vein of the retina and not of a branch vein.
The idea of the present communication is to report a case of branch vein occlusion in a case of developmental glaucoma. The obstruction originated at the arteriovenous crossing where the artery passed over the vein.
| Case Report|| |
R.S., a 17-year-old male reported to the hospital with the complaints of progressive painless diminution of vision on the left side for about 3 years.
| Examination|| |
Right eye: Normal in all respects, visual acuity 6/5 with full visual fields, tension 10.2 mm. Hg. (Schiotz).
Left eye: visual acuity finger counting at a distance of 0.50 metre with defective projection on the nasal side. Pupil was semidilated and reacting sluggishly to light. Retinoscopy revealed that the eye was myopic - 5 D sph. but there was no subjective im provement.
Fundus examination revealed advanced glaucomatous cupping of the disc with marked atrophy. Distal to the first arteriovenous crossing, the superior temporal vein and all its tributaries were very much engorged and tortuous. The blood column was more dark in colour. Nearer the site of obstruction the retina was oedematous, in which the macula was also involved. Large superficial flame-shaped haemorrhages and exudates were found scattered along the course of the vein. Retinal arteries were normal. There was no evidence of arteriosclerosis. Tension 43.4 mm. Hg. (Schiotz). Gonioscopy revealed open angle with heavily pigmented trabecular meshwork.
B.P. 110/80 mm. Hg. Urine and blood studies were, normal. No abnormal globulin could be detected in the plasma. Bleeding and clotting times - were normal. ESR 20 mm first hour (Westergreen). Mantoux test 8 mm. Serological tests for syphilis were negative
The patient was treated with diamox and 2% pilocarpine which was followed by, iridencleisis. Follow up revealed a good filtering bleb. The tension was under control. Oedema disappeared and haemorrhages and exudates got absorbed almost completely leaving a few signs. However, there was no visual improvement.
| Discussion and Comments|| |
In venous branch occlusion the impediment is probably mechanical which occurs in patients with evidence of systemic hypertension and arteriosclerosis in the retinal arteries of the affected eye. The walls of adjacent arteries and veins are intimately connected. Thickening of the arterial wall tends to obliterate the lumen of the vein and this occurs especially at the disc and at arteriovenous crossings and- it is here that one finds the obstruction. However, in this case there was no associated systemic hypertension or arteriosclerosis. There was also no increased viscosity of blood to cause venous stasis. So it appears that long-standing glaucoma, which was the only pathology associated, had something to do to bring about the obstruction but its exact role in the present case is not clear. Long-standing glaucoma may produce proliferative degenerative changes in the vein Verhoeff which would facilitate or hasten the occlusive event especially in the presence of concurrent venous stenosis. Theories of backward bulging of the lamina cribrosa due to raised intra ocular pressure. - Behrman  and sudden drop of retinal venous pressure beyond lamina cribrosa have no relevance in the present case as the site of obstruction was at, the, arterio venous crossing. beyond the level of the disc.
| Summary|| |
Retinal venous occlusion in a case of developmental glaucoma is presented. The case is interesting because the block was at the arterio venous crossing and the patient was too young for such an event.
| References|| |
BEHRMAN, S. Retinal vein obstruction. Brit. J. Ophth. 46, 336 (1962).
BERTELSEN, T. I. Relationship between thrombosis in retinal veins and primary glaucoma. Acta. Ophthal. 39, 603 (1961).
DRYDEN, R. M. Central retinal vein occlusions and chronic simple glaucoma. A.M.A. - Arch. Ophthal. 73: 659 (1965).
VERHOEFE, F. H. Effect of chronic glaucoma on central retinal vessels, Arch. Ophth. 42, 145 (1913).