Retinal vein occlusion

Retinal vein occlusion is the second most common retinal vascular disorder and a cause of painless vision loss

It is divided into branch retinal vein occlusion (most common) and central retinal vein occlusion. Each of these subdivisions are further divided into ischaemic (worse prognosis, poorer vision) and non-ischaemic. It is worth noting non-ischaemic CRVO can transform into ischaemic in 30% of cases 

BRVOpainless decrease in vision or visual field defect 
CRVO – usually sudden, painless unilateral visual loss 

  • Fundoscopy
    • Retinal haemorrhages (blot and flame shaped) 
    • Increased tortuosity of retinal veins 
    • Cotton wool spots 
    • Papilloedema 
    • Macular oedema 
  • Relative afferent papillary defect 
  • ? Fluorescein angiography 

Risk factors for RVO 
  • Age 
  • Hypertension 
  • Diabetes 
  • Smoking 
  • Hyperlipideamia 
  • Open angle glaucoma 
  • Myeloproliferative disorders – 1% of those with RVO 
  • Systemic vasculitis e.g. Behcet’s disease, PAN 

  • Refer to ophthalmology:
    • Investigation and treatment of risk factors 
    • Laser photocoagulation 
    • Anti-VEGF agents (bevacizumab, ranbizumab, pegaptanib)
    • Dexamethasone intravitreal implant 

  • Glaucoma 
  • Iris neovascularisation 

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