DIGITAL FLUORESCEIN ANGIOGRAPHY FOR THERA PEUTIC ASSESSMENT OF PATIENTS WITH CENTRAL RETINAL VEIN OCCLUSION AND CYSTOID MACULAR EDEMA - EFFECT OF A HEMODILUTION AND ACETACOLAMIDE THERAPY

Background Fluorescein angiography with a scanning laser ophthalmoscop e allows the quantification of morphologic and dynamic changes in the retina. In two patients with central retinal vein occlusion we monitor ed the progression of the cystoid macular edema (CME) and changes of m icrocirculation with a follow up of 4 to 6 months. Materials and Metho ds Two patients with central retinal vein occlusion and CME were exami ned by means of digital fluorescein angiography. Arteriovenous passage times and macular capillary blood velocities in combination with quan tifications of the macular angioarchitecture and the extent of the CME were evaluated. Results Hemodilution therapy improved retinal circula tion, whereas macular circulation and the severity of the CME remained unchanged. With persisting CME oral acetazolamid therapy was initiate d. Oral Acetazolamide led to resorption of the cystoid edema in tandem with improved macular circulation. The capillary density was altered but remained unchanged over time. Conclusions By means of digital anal ysis of fluorescein angiograms a detailed monitoring of retinal and ma cular dynamics, macular morphology is possible. In these two cases CME improved after Acetazolamide and moreover retinal circulation returne d to normal conditions.