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Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia

A 74-year-old female patient visited our department reporting unilateral painless vision reduction in her left eye noticed a few months ago. Clinical examination revealed decreased visual acuity in the left eye. Fundoscopy showed bilateral retinal venous stasis with cystoid macular edema in the affe...

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Detalles Bibliográficos
Autores principales: Chaloulis, Stergios K, Tsaousis, Konstantinos T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794224/
https://www.ncbi.nlm.nih.gov/pubmed/35111466
http://dx.doi.org/10.7759/cureus.20782
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author Chaloulis, Stergios K
Tsaousis, Konstantinos T
author_facet Chaloulis, Stergios K
Tsaousis, Konstantinos T
author_sort Chaloulis, Stergios K
collection PubMed
description A 74-year-old female patient visited our department reporting unilateral painless vision reduction in her left eye noticed a few months ago. Clinical examination revealed decreased visual acuity in the left eye. Fundoscopy showed bilateral retinal venous stasis with cystoid macular edema in the affected eye, also confirmed by optical coherence tomography (OCT) imaging. OCT angiography showed no evidence of ischemia. Bilateral findings raised suspicion for a systemic underlying cause. Laboratory tests showed elevated homocysteine plasma levels. Brain MRI showed ischemic encephalopathy. Hyperhomocysteinemia creates a hypercoagulable state and therefore it is a risk factor for vascular thrombosis and retinal vein occlusion. Our patient was considered to suffer from an impending retinal vein occlusion due to venous stasis, causing a persistent macular edema, and, therefore, was treated with anti-vascular endothelial growth factor (VEGF) injections. She was also prescribed oral folic acid for life. Her visual acuity showed improvement and remained stable for a long period of time. When macular edema reoccurred she was treated with another intravitreal injection.
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spelling pubmed-87942242022-02-01 Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia Chaloulis, Stergios K Tsaousis, Konstantinos T Cureus Internal Medicine A 74-year-old female patient visited our department reporting unilateral painless vision reduction in her left eye noticed a few months ago. Clinical examination revealed decreased visual acuity in the left eye. Fundoscopy showed bilateral retinal venous stasis with cystoid macular edema in the affected eye, also confirmed by optical coherence tomography (OCT) imaging. OCT angiography showed no evidence of ischemia. Bilateral findings raised suspicion for a systemic underlying cause. Laboratory tests showed elevated homocysteine plasma levels. Brain MRI showed ischemic encephalopathy. Hyperhomocysteinemia creates a hypercoagulable state and therefore it is a risk factor for vascular thrombosis and retinal vein occlusion. Our patient was considered to suffer from an impending retinal vein occlusion due to venous stasis, causing a persistent macular edema, and, therefore, was treated with anti-vascular endothelial growth factor (VEGF) injections. She was also prescribed oral folic acid for life. Her visual acuity showed improvement and remained stable for a long period of time. When macular edema reoccurred she was treated with another intravitreal injection. Cureus 2021-12-28 /pmc/articles/PMC8794224/ /pubmed/35111466 http://dx.doi.org/10.7759/cureus.20782 Text en Copyright © 2021, Chaloulis et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Chaloulis, Stergios K
Tsaousis, Konstantinos T
Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title_full Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title_fullStr Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title_full_unstemmed Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title_short Cystoid Macular Edema Associated With Venous Stasis in a Patient With Previously Undiagnosed Hyperhomocysteinemia
title_sort cystoid macular edema associated with venous stasis in a patient with previously undiagnosed hyperhomocysteinemia
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794224/
https://www.ncbi.nlm.nih.gov/pubmed/35111466
http://dx.doi.org/10.7759/cureus.20782
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