Ayurvedic Management of Branch Retinal Vein Occlusion After Dexamethasone Implant: A Case Report with BCVA and OCT Follow-up
DOI:
https://doi.org/10.70066/jahm.v14i9.3051Keywords:
Case Report, Cystoid Macular Edema, Retinal Vein Occlusion, Trutiya Patalagata TimiraAbstract
Background: Branch retinal vein occlusion (BRVO) is a vision threatening retinal-vascular disease. Ayurveda correlates BRVO with Trutiya patalagata Timira, a disease manifested by the vitiated Tridosha with Rakta (blood) entering the Trutiya Patala causing Sanga (obstruction), Vimargagamana (deranged movement) of Rakta, which results in distortion and sudden diminution of vision. Case Presentation: A 41 year old hypertensive male patient presented with sudden painless diminution of distant vision and metamorphopsia in the right eye (RE) and initially managed with dexamethasone intravitreal implant. Best Corrected Visual Acuity (BCVA) was LogMAR 0.301 in RE, LogMAR 0 in LE. His fundus photo showed hard exudates, multiple dot and blot hemorrhages and macular edema, whereas Optical Coherence Tomography (OCT) Central Macular Thickness (CMT) 624 µm and Total Volume (TV) 11.60 mm³ confirm the cystoid macular edema (CME) and BRVO. Intervention: From March to December 2025, the patient attended three outpatient visits, including the initial consultation and two follow-ups, and completed one 14-day inpatient treatment. He received Shodhana (purification), Raktaprasadana (refines Rakta Dhathu), Bruhmana (nourishment) medications and treatments both internally and externally, along with Kriyakalpa (ocular therapeutic procedures). Outcome: Post-treatment evaluation revealed symptomatic and functional improvement in BCVA LogMAR 0.301→LogMAR 0, symptoms like distortion, diminution in vision and CME with CMT 624 µm→156 µm. Conclusion: This case report documents the clinical and OCT based improvement observed during Ayurvedic management of CME secondary to chronic BRVO previously treated with dexamethasone implant. Due to single-case design, prior dexamethasone implant, and natural fluctuations, direct causality cannot be confirmed.
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