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Journal of Postgraduate Medicine, Vol. 53, No. 4, October-December, 2007, pp. 270-271 Letter Authors' reply Issa S Ophthalmology Department, Royal Victoria Infirmary, Queen Victoria Road Newcastle Upon Tyne Code Number: jp07094 Related articles: jp07067 , jp07093 Sir, We would like to thank the author [1] for his interest in our case report. [2] We agree with the author that it is important to make a distinction between ischemic and non-ischemic central retinal vein occlusion (CRVO). The case report we described would indeed fit the diagnosis of a non-ischemic CRVO. However, in our experience and other authors′ report, CRVOs which are associated with thrombotic thrombocytopenic purpura do not usually resolve quickly. [3] Even if the retinal hemorrhages and the venous stasis resolve gradually, the residual macular edema becomes chronic and usually does not improve. It might seem to the reader that we were a bit hasty in applying the laser treatment and that we could have waited a bit longer to see if the edema would resolve spontaneously. However, on clinical grounds, we did not feel that the edema was resolving as quickly as the retinal hemorrhages and venous stasis. At that time, we believed that complete spontaneous resolution of the macular edema was unlikely. Another fact was that the patient had an active life and wished for a quicker restoration of vision. This was the first time that we have tried macular grid laser treatment in such a case and the quicker resolution of the patient′s macular edema and restoration of vision to 6/6 was in favor of our judgment. References
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