Digitale fluoreszein-angiographie zur kontrolle des klinischen verlaufes unter therapie bei patienten mit zentralvenenverschluss und zystoidem makulaodem

Background: Fluorescein angiography with a scanning laser ophthalmoscope allows the quantification of morphologic and dynamic changes in the retina. In two patients with central retinal vein occlusion we monitored the progression of the cystoid macular edema (CME) and changes of microcirculation with a follow up of 4 to 6 months. Materials and Methods: Two patients with central retinal vein occlusion and CME were examined by means of digital fluorescein angiography. Arteriovenous passage times and macular capillary blood velocities in combination with quantifications of the macular angioarchitecture and the extent of the CME were evaluated. Results: Hemodilution therapy improved retinal circulation, whereas macular circulation and the severity of the CME remained unchanged. With persisting CME oral acetazolamid therapy was initiated. 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 analysis of fluorescein angiograms a detailed monitoring of retinal and macular dynamics; macular morphology is possible. In these two cases CME improved after Acetazolamide and moreover retinal circulation returned to normal conditions.