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Branch Retinal Vein Occlusion (BRVO)


Other names:

Central retinal vein occlusion, CRVO.

What is a retinal vein occlusion?

A retinal vein occlusion is a blockage of the blood supply from the retina, the light-sensitive tissue in the back of the eye, leading to sudden complete or partial loss of vision. This is typically caused by a tiny embolus (blood clot or fatty deposit) in the blood stream.

macular hole

 

What causes retinal vein occlusion?

Retinal veins can become blocked by a blood clot. Retinal vein occlusion can also occur when the retinal arteries put pressue on the retinal vein, resulting in ischemia (lack of oxygen), edema (swelling) and glaucoma. The vein may rupture (tear), spilling blood and fluid into the vitreous, blurring and clouding vision over a few hours. Blockage of a retinal artery is an emergency, like retinal detachment. Without a blood supply, the rod and cone cells of the retina will die.

Retinal vein occlusion is usually caused by conditions such as:

Who is at risk for retinal vein occlusion?

Retinal vein occlusion more often affects older people. Risk factors include hypertension, hypercholesterolemia, diabeties, atherosclerosis, or history of stroke or transient ischemic attack (TIA).

What are the symptoms of retinal vein occlusion?

Sudden, painless, loss of vision, in all or part of the eye. Call your eye care professional if you experience these symptoms.

What tests are performed to diagnose retinal vein occlusion?

Some of the tests to evaluate the retina may include:

dilated exam

Dilated Eye Exam - Drops are placed in your eyes to widen (dilate) the pupils. This allows the eye care professional to see more of the inside of your eyes to check for signs of the disease. Your eye care professional uses a special magnifying lens to examine your retina for signs of damage.


Fluorescein angiography - Performed to evaluate the blood vessels in your eyes for retinal disease. This requires a small injection of vegetable dye into a vein in your arm. Serial photos are taken of your retina through a dilated pupil.


eye pressure

Tonometry - An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.


Retinal Photography - High resolution images of the retina are taken, to help document changes in the retina.


Slit Lamp Exam - A microscope is used for examining the eye; allowing for the cornea, lens and otherwise clear fluids and membranes to be seen in layer-by-layer detail.


What can I do to prevent retinal vein occlusion?

Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease, may decrease the risk of retinal artery occlusion. These include:

What is the treatment for retinal vein occlusion?

The outcome varies. In the early stages, usually no treatment is needed at all. However, sometimes laser surgery may be beneficial if there are new leaking blood vessels or leaking fluid. This is an in-office procedure, usually causing no pain. You can return to normal activities right away. Many patients with branch retinal vein occlusions often regain their site. Recovery from a central vein occlusion is much less likely, since it affects the macula.

Please call the office if you notice a noticeable decline in vision, any new floaters, any pressure or pain in your eye.

Research

Clinical trials are now underway to determine whether drugs that stop the growth of abnormal blood vessels (anti-VEGF drugs) might help treat retinal vein occlusion.

References

Wu L, Arevalo JF, Roca JA, Maia M, Berrocal MH, Rodrigues FJ, et al. Pan-American Collaborative Retina Study Group (PACORES). Comparison of two doses of intravitreal bevacizumab (Avastin) for treatment of macular edema secondary to branch retinal vein occlusion: results from the Pan-American Collaborative Retina Study Group at 6 months of follow-up. Retina 2008;28:212-219.

Kreutzer TC, Alge CS, Wolf AH, Kook D, Burger J, Strauss R, et al. Intravitreal bevacizumab for the treatment of macular edema secondary to branch retinal vein occlusion. Br J Ophthalmol 2008;92:351-355.

Disclaimer: The information contained in this website does not substitute for the advice of a qualified eye care professional and is not intended to constitute medical advice.