A patient with a past medical history of hypertension presented with vision loss in the right eye for two days. His exam was notable for visual acuity of hand motions in the right eye and 20/20 in the left eye. Intraocular pressures and slit lamp exam were normal in both eyes. Posterior segment exam revealed a vitreous hemorrhage in the right eye, and was normal in the left eye without retinopathy. A B-scan demonstrated no retinal detachment in the right eye. A fluorescein angiography demonstrated a retinal vascular occlusion with neovascularization, and the patient was treated with intravitreal ranibizumab. After a second injection the following month, the patient developed an episode of hemisensory loss. He was admitted at an outside hospital and diagnosed with a transient ischemic attack as well as hypertension. His systemic symptoms resolved and he was started on blood pressure and stroke prevention treatment. His eye was observed without further injections. Nine months later, the patient presented with recurrent vitreous hemorrhage in the right eye. Risks and benefits were discussed with the patient, and intravitreal ranibizumab was given with no systemic side effects.
Presentation Date: 09/01/2022
Issue Date: 09/09/2022