Iris Neovascularization After Central Retinal Vein Occlusion

Slit lamp images of an 80 year old man with primary open angle glaucoma who developed an ischemic central retinal vein occlusion that evolved to cause anterior segment neovascularization and neovascular glaucoma. The eye received intravitreal bevacizumab injection and laser panretinal photocoagulation but eventually lost all vision despite therapy. A - The elevated intraocular pressure has led to corneal microcystic edema indicated by the irregular light reflex (black arrow). The iris new vessels begin at the pupillary margin, next involve the angle (not shown) and eventually spread across the iris stroma, remaining densist near the pupillary margin. B - The eye is inflamed with injected conjunctiva (black arrow) and posterior synechia to the lens capsule (blue arrow). The mesh of neovascularization on the iris surface (turquoise arrow) eventually will retract and cause ectropion uvea (not shown).