Retinal Vein Occlusion

Retinal vein occlusions result from the blockage of the main vein (Central Retinal Vein Occlusion/CRVO) or one of the tributaries (Branch Retinal Vein Occlusion/BRVO) that drain blood from the eye. This blockage results in lack of oxygen circulation in the retina (ischemia), as well as the leakage of blood and plasma fluid into retinal tissue which can both contribute to vision loss. This may result in the development of abnormal new blood vessels which may require additional treatment.  The blockage is not typically caused by a blood clot (although in some unusual cases it may be), but rather is due to the anatomy of the ocular blood circulation. Over time, blood vessels that cross over each other in the retina may begin to impinge on the blood flow through the vessels and a blockage develops.

The risk factors for both central retinal vein occlusion or branch vein occlusion are similar and include high blood pressure, diabetes, cardiovascular disease, and glaucoma. If no predisposing risk factors are identified, a complete physical exam with laboratory examinations may be recommended. Some younger patients may need additional work up for blood clotting disorders.

Treatment for vision loss from vein occlusions is intended to decrease swelling of the retina (macular edema) which affects the central vision. There are a variety of medications that are effective in reducing macular edema. These medicines require injection into the back of the eye (vitreous) for maximum effect. The number of treatments and length of treatment time is variable with most patients requiring multiple injections over time. Laser treatment may be added in select few patients to treat macular edema or abnormal new blood vessels which develop in response to decreased oxygen circulation. In many patients, a ‘detour’ around the blockage will naturally develop over a period of 1-2 years and often treatments can eventually be discontinued.

For more information about this condition:

1) Branch Retinal Vein Occlusion information from the ASRS Retinal Health series

2) Central Retinal Vein Occlusion information from the ASRS Retinal Health series

3) Informational video about Branch Retinal Vein Occlusion from the American Academy of Ophthalmology:

 

4) Informational video about Central Retinal Vein Occlusion from the American Academy of Ophthalmology: