Summary

This case study explores the histopathological findings 9 months after retinal endovascular lysis (REVL) in a 62-year-old woman having a 7-week-old, highly ischaemic central retinal vein occlusion (CRVO) with hand movement vision. Angiographic examination 3 days postoperatively did not show improved arteriovenous passage time. In addition, the patient’s postoperative vision did not change, and despite intensive photocoagulation and cryotherapy in the early postoperative period, the globe had to be removed 9 months later because of painful phthisis. Histological findings at the site of puncture were epiretinal membrane, interrupted internal limiting membrane and thickened venous wall. This is the first case to show the histological changes after surgical REVL in a human eye. In this case, REVL did not prevent neovascular glaucoma despite successful recombinant tissue plasminogen activator (rt-PA) injection in a venous branch close to the papilla. It was concluded that rt-PA injection after 7 weeks of CRVO is too late.