Retinal Vein Occlusion
Definition
Retinal vein occlusion (RVO) occurs when a vein that drains blood from the retina becomes blocked. This blockage prevents normal blood flow, leading to retinal swelling, bleeding, and vision loss. RVO is the second most common retinal vascular disease after diabetic retinopathy.
Types of Retinal Vein Occlusion
1. Central Retinal Vein Occlusion (CRVO)
- Blockage of the main retinal vein.
- Usually affects the entire retina.
2. Branch Retinal Vein Occlusion (BRVO)
- Blockage of one of the smaller retinal vein branches.
- Usually affects only part of the retina.
Causes
RVO occurs when normal blood flow through a retinal vein is disrupted, often due to:
- A blood clot within the retinal vein
- Compression of a vein by a nearby artery
- Reduced blood flow causing retinal oxygen deficiency and swelling (macular edema)
Risk Factors
People with the following conditions have a higher risk:
- High blood pressure (hypertension)
- Diabetes mellitus
- Glaucoma
- Arteriosclerosis (hardening of the arteries)
- Other vascular (blood vessel) diseases
- Age over 50 years
Symptoms usually affect only one eye.
Common Symptoms
- Blurred vision
- Sudden or gradual vision loss
- Floaters (spots or lines in vision)
- Eye pain or pressure (particularly if glaucoma develops)
Possible Complications
- Macular edema (swelling of the macula)
- Neovascular glaucoma
- Retinal bleeding
- Retinal detachment
Dilated Eye Examination
Allows detailed visualization of retinal hemorrhages, swelling, and blocked veins.
Optical Coherence Tomography (OCT)
Measures retinal swelling and macular edema.
Fluorescein Angiography
Uses dye to identify blocked or leaking blood vessels.
OCT Angiography (OCTA)
Evaluates retinal blood vessels without dye injection.
Anti-VEGF Injections
Reduce retinal swelling and abnormal blood vessel growth.
Steroid Injections or Implants
May reduce inflammation and macular edema.
Laser Treatment
Used in selected cases to treat complications such as abnormal blood vessel growth.
Risk Factor Management
- Control blood pressure
- Manage diabetes
- Treat glaucoma
- Address cardiovascular disease risk factors
While RVO cannot always be prevented, risk can be reduced by:
- Maintaining healthy blood pressure
- Managing diabetes effectively
- Regular eye examinations, especially after age 50
- Controlling glaucoma and vascular disease risk factors
Retinal vein occlusion is a blockage of a retinal vein that causes retinal swelling, bleeding, and vision loss. The two major types are CRVO and BRVO. Treatment typically involves anti-VEGF injections, laser therapy, and management of underlying cardiovascular risk factors. Early diagnosis improves the chance of preserving vision.
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