title: Treatment of systemic hypertension is important for improvement of macular edema associated with retinal vein occlusion.
abstract: BACKGROUND
  We report our findings in three cases of unilateral macular edema associated with retinal vein occlusion (RVO) that improved after successful treatment of systemic hypertension alone.
  
  
  METHODS
  All three cases had systemic hypertension but no diabetes mellitus or other ocular diseases associated with macular edema. All patients were treated only with medication for systemic hypertension. Optical coherence tomography was performed to determine the foveal thickness before and after treatment.
  
  
  RESULTS
  Case one was a 72-year-old woman with a central RVO who had macular edema in her left eye and a visual acuity (VA) of 20/50. Her blood pressure (BP) was 169/96 mmHg. One month after the initiation of a calcium blocker to treat her systemic hypertension, her BP was decreased, macular edema was reduced, and her VA improved to 20/20. Case two was a 62-year-old woman with branch RVO. Her VA was 20/40 and her BP was 165/97 mmHg. Six weeks after initiation of medication to treat her systemic hypertension, her RVO-related macular edema had decreased and her VA improved to 20/20. Case three was a 71-year-old man with branch RVO. His VA was 20/50 and his BP was 165/87 mmHg. One month after initiation of treatment for systemic hypertension, his RVO-related macular edema had disappeared and his VA improved to 20/20. All three cases had nonischemic RVO by fluorescein angiography, and they did not develop ischemic changes for at least 1 year.
  
  
  CONCLUSIONS
  The reduction of macular edema following a decrease in the systemic hypertension suggests that the edema was most likely caused by leakage of fluids from the blood vessels. We recommend that the blood pressure should be measured in all patients with macular edema before initiating intravitreal anti-VEGF therapy.
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Teruyo
authors.initials: T
authors.lastname: Kida
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Seita
authors.initials: S
authors.lastname: Morishita
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Kakurai
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Oku
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Osaka, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
keywords: anti-VEGF therapy; early treatment; frequent injection; high cost