Visible Blood Flow in a Case of Rubeosis Iridis

A 72-year-old Japanese woman presented to our hospital with decreased vision. At the initial visit, her best-corrected visual acuity (BCVA) and intraocular pressure (IOP) in her right eye (OD) were 0.02 and 36 mm Hg, respectively. By slit lamp examination, rubeosis iridis was observed on the iris surface. With higher magnification observation, movement of clustered RBCs were clearly observed; the blood drained into episcleral vessels that were connected with the main trunk of rubeosis iridis. She was diagnosed with the neovascular glaucoma secondary to central retinal vein occlusion OD. She underwent panretinal photocoagulation, intravitreal injection of aflibercept, and Ahmed Glaucoma Valve implantation. At 2 weeks postoperatively, the BCVA and IOP OD were 0.2 and 7 mm Hg, respectively; rubeosis iridis was partially regressed and movement of RBCs was not observed. Acquisition of directional flow by the connection of the main trunk of neovessels with the episcleral vessels and reduction of flow speed by the high IOP could explain the reason for visible blood flow in our case.