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Treatment of systemic hypertension is important for improvement of macular edema associated with retinal vein occlusion

Authors Kida T, Morishita S, Kakurai K, Suzuki H, Oku H, Ikeda T

Received 2 March 2014

Accepted for publication 31 March 2014

Published 16 May 2014 Volume 2014:8 Pages 955—958

DOI https://doi.org/10.2147/OPTH.S63368

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3


Teruyo Kida, Seita Morishita, Keigo Kakurai, Hiroyuki Suzuki, Hidehiro Oku, Tsunehiko Ikeda

Department of Ophthalmology, Osaka Medical College, Osaka, Japan

Background: We report our findings in three cases of unilateral macular edema associated with retinal vein occlusion (RVO) that improved after successful treatment of systemic hypertension alone.
Methods: All three cases had systemic hypertension but no diabetes mellitus or other ocular diseases associated with macular edema. All patients were treated only with medication for systemic hypertension. Optical coherence tomography was performed to determine the foveal thickness before and after treatment.
Results: Case one was a 72-year-old woman with a central RVO who had macular edema in her left eye and a visual acuity (VA) of 20/50. Her blood pressure (BP) was 169/96 mmHg. One month after the initiation of a calcium blocker to treat her systemic hypertension, her BP was decreased, macular edema was reduced, and her VA improved to 20/20. Case two was a 62-year-old woman with branch RVO. Her VA was 20/40 and her BP was 165/97 mmHg.
Six weeks after initiation of medication to treat her systemic hypertension, her RVO-related macular edema had decreased and her VA improved to 20/20. Case three was a 71-year-old man with branch RVO. His VA was 20/50 and his BP was 165/87 mmHg. One month after initiation of treatment for systemic hypertension, his RVO-related macular edema had disappeared and his VA improved to 20/20. All three cases had nonischemic RVO by fluorescein angiography, and they did not develop ischemic changes for at least 1 year.
Conclusion: The reduction of macular edema following a decrease in the systemic hypertension suggests that the edema was most likely caused by leakage of fluids from the blood vessels. We recommend that the blood pressure should be measured in all patients with macular edema before initiating intravitreal anti-VEGF therapy.

Keywords: anti-VEGF therapy, early treatment, frequent injection, high cost

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