Central Retinal Vein Occlusion



Central Retinal Vein Occlusion





SALIENT FEATURES



  • Retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy.1


  • In central retinal vein occlusion (CRVO), the occlusion is at or proximal to the lamina cribosa of the optic nerve. CRVO is divided into two categories which affect treatment and prognosis: nonischemic and ischemic.2


  • CRVOs are most commonly associated with advanced age and hypertension, but other risk factors include glaucoma, diabetes, hyperlipidemia, and various hypercoagulable conditions.2


  • Acute CRVO is a clinical diagnosis manifesting intraretinal hemorrhages in all quadrants, dilated tortuous retinal vasculature, cotton wool spots, optic disc edema, and macular edema.2


  • In nonischemic CRVOs, visual acuity (VA) is typically better than 20/200 with no relative afferent pupillary defect (RAPD) and an overall good prognosis for visual recovery. In ischemic CRVOs, VA is typically worse than 20/200 with an RAPD, a high chance of anterior segment neovascularization, and an overall poor prognosis for visual recovery.3


  • In chronic CRVO, small vessels that normally connect the retinal and choroidal circulation near the optic nerve head expand and develop into optociliary shunt vessels which redirect venous drainage from the occluded central retinal vein to the choroid, vortex veins, and ophthalmic veins.3



OCT IMAGING

May 10, 2021 | Posted by in OPHTHALMOLOGY | Comments Off on Central Retinal Vein Occlusion
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