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What is Retinal Vein Occlusion?

Retinal vein occlusion is a serious condition that occurs when a blood vessel in the retina—the light-sensitive layer at the back of the eye—becomes blocked. This blockage, similar to a stroke in the brain, can cut off the supply of oxygen and nutrients to the retina, causing vision to become blurred or lost. The severity of vision loss depends on the size and location of the blocked vein. Retinal vein occlusion is classified based on the type of blood vessel that is blocked.

  • Branch Retinal Vein Occlusion (BRVO)

    • BRVO occurs when a smaller, branch retinal vein becomes blocked. This blockage affects a limited area of the retina, often leading to a partial loss of vision.

  • Central Retinal Vein Occlusion (CRVO)

    • CRVO is a more severe condition where the main retinal vein becomes blocked. This affects the entire retina, typically causing a sudden and significant loss of vision.

BRVO
CRVO

Symptoms of Retinal Vein Occlusion

The symptoms of retinal vein occlusion are typically sudden and painless. They may include:

  • Sudden, painless vision loss in all or part of one eye.

  • Blurred or distorted vision.

  • A dark or blind spot in your field of vision.

  • Floaters, which are small specks or threads that drift across your vision.

How does Retinal Vein Occlusion Affect Your Vision?

When a retinal vein is blocked, the retina cannot get the oxygen and nutrients it needs to function properly. This leads to a buildup of fluid and blood in the retina, causing swelling (macular edema) and damage to the light-sensitive cells. If left untreated, this damage can lead to permanent vision loss.

Causes of Retinal Vein Occlusion

Retinal vein occlusion is often caused by a blood clot or plaque that travels from other parts of the body and blocks a retinal blood vessel.

  • Risk Factors

    • The primary risk factors for retinal vein occlusion are often related to cardiovascular health. These include:

      • High blood pressure (Hypertension): The most common risk factor.

      • Atherosclerosis: A buildup of plaque in the arteries, which can lead to blockages.

      • Diabetes: High blood sugar can damage blood vessels throughout the body, including the retina.

Risk Factors

What happens to you after Retinal Vein Occlusion? (Complications)

Even after the initial event, retinal vein occlusion can lead to serious complications if not managed properly.

  • Macular Edema

    • This is a very common complication and the leading cause of vision loss following a retinal vein occlusion. Fluid leaks from damaged blood vessels, causing the macula to swell.

  • Vitreous Hemorrhage

    • Abnormal new blood vessels can grow in the retina, which are fragile and can bleed into the vitreous gel, causing a sudden loss of vision.

  • Retinal Detachment

    • The growth of new blood vessels and scar tissue can pull on the retina, leading to a retinal detachment.

  • Neovascular Glaucoma

    • In severe cases, the abnormal new blood vessels can grow on the iris and block the eye's drainage angle, causing a rapid and painful increase in eye pressure.​

Macular Edema
Vitreous Hemorrhage
Retinal Detachment
Neovascular Glaucoma

Diagnosis of Retinal Vein Occlusion

An ophthalmologist can diagnose a retinal vein occlusion during a comprehensive eye examination. The diagnosis typically involves:

  • A Dilated Eye Exam: To view the retina and optic nerve.

  • Fluorescein Angiography: This is considered a gold standard for evaluating retinal circulation. A dye is injected into a vein in your arm, and a series of photographs are taken as the dye circulates through the blood vessels of your retina, revealing areas of leakage or blockage.

  • Optical Coherence Tomography (OCT): An OCT scan provides a detailed cross-sectional image of the retina, allowing the doctor to see the swelling and fluid buildup.

  • OCT Angiography: This imaging technique allows the doctor to see the blood vessels in the retina in detail, identifying the location and extent of the blockage.

Management and Treatment of Retinal Vein Occlusion

The goal of treatment is to reduce retinal swelling and prevent the growth of new, abnormal blood vessels.

  • Anti-VEGF Intravitreal Injection

    • This is the most common and effective treatment. Anti-VEGF agents are injected directly into the eye to block the growth of new blood vessels and reduce swelling.

  • Vitrectomy

    • In cases with significant vitreous hemorrhage or retinal detachment, vitrectomy surgery may be necessary to remove the blood and repair the retina.

  • Laser Photocoagulation

    • This treatment uses a laser to coagulate areas of the retina with poor blood supply, thereby reducing the eye's oxygen consumption. This helps prevent the growth of new, abnormal blood vessels and fluid leakage, thereby preserving future vision.​

Anti-VEGF
Vitrectomy
Laser photocoagulation
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