Retinal Vein Occlusion
A retinal vein occlusion occurs when hardened and thickened arteries compress a vein, which causes the blood flow to be impeded. This results in damage to the blocked blood vessel with subsequent fluid leakage and swelling in the retinal tissue. In addition, this obstruction can lead to retinal stress, hemorrhaging, and permanent damage as oxygen and other nutrients are not adequately delivered to the retinal tissue.
Types of RVO
There are two primary types of vein occlusion: branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). BRVO involves the blockage of a single branch of the retinal venous system, while CRVO is a blockage of the entire retinal venous system. In addition, the severity of vision loss from BRVO and CRVO often relates to how much of the blood flow is obstructed. If all or most of the blood flow is blocked off to the retina, there can be permanent and severe vision loss, while if blood flow is only minimally affected, there may be no symptoms at all.
Risk Factors, Causes, & Symptoms
The main risk factors for retinal vein occlusion include age, high blood pressure, diabetes, smoking, and glaucoma. These occlusions typically occur in individuals over the age of 55. If a BRVO or CRVO occurs in a younger patient without clear risk factors, it’s important to refer them to a primary care physician or hematologist. In cases of vein occlusions, patients often experience loss of either central or peripheral vision, depending on where the occlusion occurs. Symptoms can appear suddenly or develop gradually, worsening over the course of days, weeks, or months.
Treatments
Systemic risk factors should be optimized, including blood pressure and diabetes control. If patients smoke, it is important to stop smoking, as smoking leads to continued blood vessel inflammation and damage. If systemic risk factors are not under control, the treatments we can provide to the eye may not help improve the vision. It is also important to control systemic risk factors as much as possible to reduce the risk of a BRVO or CRVO occurring in the fellow eye. The mainstay of treatment for BRVO and CRVO consists of medication directly injected into the eye.
These injections, very similar to those used to treat diabetic eye disease and AMD, work to reduce the swelling or edema that develops in the macula (central retina) of patients with BRVO and CRVO. With treatment, many patients will achieve significant improvement in their vision. Injections are given once a month until the edema from the vein occlusion resolves. Additional treatment beyond that point is highly patient-specific, with some patients not requiring any further treatment, and some patients requiring monthly injections for several years.
In some cases, laser treatment may also be necessary in the treatment of retinal vein occlusions. Laser treatment is done in our office, and is typically used in cases where the occlusion is severe and abnormal blood vessels (neovascularization) begin to grow and cause problems in the eye, such as vitreous hemorrhage and rapid onset glaucoma.
Schedule a Consultation for Retinal Vein Occlusion
At Mid Atlantic Retina Specialists, our team of experienced retina specialists can diagnose and treat a wide variety of retinal conditions, including retinal vein occlusion. Request an appointment today at one of our retina centers in Hagerstown, MD, Frederick, MD, Chambersburg, PA, or Bedford, PA.
