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Answers: 2006 Series -  June 20, 2006 Lecture 28 of 52  NEXT»

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A 62 year-old man presents with decreased vision in his right eye and on examination you find the above.    

When should you consider ordering a fluoroscein angiogram or OCT in such a patient to determine treatment options?   

     c --  Usually after 8 weeks and if clinical findings indicate

A fluorescein angiogram should be obtained when the hemorrhages have cleared if the patient's vision is still reduced. Tests are usually done 3 months after the event.
 
Purpose of test is to determine cause of visual loss (macular edema or ischemia). If visual loss is secondary to macular edema, laser photocoagulation in a grid pattern may be of benefit (See BVOS Study Results) . If macular ischemia is responsible for the loss of vision, laser photocoagulation should not be offered to the patient.
 
A FA is also useful for showing precise site of venous obstruction if surgery is contemplated.
 
Of note, an OCT can be obtained to follow macular edema.

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