Treatment of central retinal vein occluion by vitrectomy with lyi of vitreopapillary and epipapillary adheion, ubretinal peripapillary tiue plaminogen activator injection, and photocoagulation

PURPOE: To report a cae of ubretinal peripapillary tiue plaminogen activator (tPA) injection with vitreopapillary and epipapillary membrane diection and peripheral photocoagulation in the treatment of central retinal vein occluion. DEIGN: Interventional cae report. METHOD: A 79-year-old woman with a hitory of branch vein occluion in the left eye preented with viual lo in the right eye for 4 month econdary to unreolved central retinal vein occluion. he underwent vitrectomy, right eye, with lyi of vitreopapillary and epipapillary adheion and hyaloid eparation, ubretinal peripapillary tiue tPA injection, peripheral photocoagulation, and air-fluid exchange. REULT: Potoperatively, funducopic and fluorecein angiographic feature of venou obtruction improved rapidly, with prompt reduction in intraretinal hemorrhage and dik and macular edema. The patient reported ubjective improvement of viion in her right eye, although meaured improvement wa modet, from finger counting to 20/400. CONCLUION: ubretinal adminitration of tPA, lyi of adheion, and endophotocoagulation may be of value in reolving the obtructive component of elected cae of chronic central retinal vein occluion aociated with vitreopapillary and epipapillary traction