Retinal Vein Occlusion

Retinal vein occlusion is where a clot forms in retinal veins and blocks drainage of blood from the retina. This causes leads to:

• Pooling of blood in the retina

• Macular oedema and retinal haemorrhage

• Retinal tissue damage and Vision loss

• Release of VEGF, which stimulates neovascularisation

It can be categorised into Ischaemic and Non-ischaemic, with the ischaemic type having a:

• Worse vision

• More complications

• Worse prognosis for vision

Risk factors - HTN, High cholesterol, DM, Smoking, Glaucoma, SLE

Complications:

• Neovascularisation – Due to release of VEGF

• Vitreous haemorrhage – Due to bleeding of new vessels

Presentation

• Sudden painless vision loss

• O/E:

  • Stormy-sunset appearance

  • Flame and blot haemorrhages

  • Macular oedema

  • Dilated/tortuous retinal veins

Investigations

• Bloods - FBC, U&E, LFT, CRP/ESR, Lipids, Clotting, Glucose

• BP

Management

• Laser photocoagulation for neovascularisation

• Anti-VEGF for macular oedema

  • Steroids if contraindicated e.g. CVA within 3 months, pregnancy