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RVO

by | Conditions

RVO

Retinal Vein Occlusion (RVO)

Symptoms, Diagnosis & Treatment

 

The retina is the thin, innermost and photosensitive tissue located at the back of the eye. It is where all the photoreceptors, both rods and cones, are located. The light focused by the lens is transmitted to the retina where it is converted into neural signal and forwarded to brain for visual interpretation.

Retinal veins carry blood away from the retina. This condition in which the veins are damaged and impair the function of the retina is called retinal vein occlusion (RVO). In other terms, it is sometimes known as eye stroke. There are two types of RVO depending upon the extent of the retina involved:

  • Central retinal vein occlusion (CRVO)
  • Branch Retinal vein Occlusion (BRVO)

What Causes a Vein Occlusion?

In the eye, veins and arteries overlap each other at multiple sites. There can be a problem of an artery which also damages the vein. Usually, the artery hardens and exerts pressure on veins which leads to compression of the vein. As far as the involvement of veins is concerned, this clinical emergency usually occurs when the veins have hardened over a long period of time or in the setting of high blood pressure.   The most commonly observed underlying conditions are diabetes and hypertension.

Some other associated conditions are:

  • Smoking
  • High cholesterol
  • Being overweight
  • Older age
  • Hardened arteries, called atherosclerosis
  • Eye Trauma
  • Glaucoma

How Serious is a Vein Occlusion?

A vein occlusion is a very serious problem.  Acute loss of vision is the most common consequence of retinal vein occlusion. Patients usually present with new-onset blurred vision.  There usually is no pain.  There may be some eye floaters.  Many of the symptoms of a vein occlusion can overlap with diabetic retinopathy, macular degeneration, or retinal detachment.  It can be difficult for the patient to tell what is going on as the symptoms can be sudden or more gradual.

Symptoms of Acute Vision Loss

  • Floaters
  • Lightning flashes in the eye
  • Blurry or cloudy vision
  • The complete absence of vision
  • Loss of vision in either peripheral or central vision
  • Eye pain (rarely)
  • Headache

Diagnosis of RVO

  • Ophthalmoscopy: Few drops are put into your eyes to dilate the pupils and then your eyes are checked for any blockage or bleeding in the retina.
  • Fluorescein angiography: A dye is injected which enters your blood circulation. Then your eyes are checked with a camera to see any leakage from veins or arteries.  It can help determine the extent of the blockage.
  • Coherence Tomography (OCT):  Used to look for swelling in the center vision related to the vein occlusion.

How do you Treat a Vein Occlusion?

RVO is an irreversible condition.   The goal of treatment is to manage the two most common complications related to a vein occlusion – macular edema or new blood vessel growth.  Typically, eye injections can yield good anatomic results in patients with vein occlusion.  A laser can be used to stop abnormal blood vessel growth inside the eye that can lead to pain or worsening floaters.  Early treatment can preserve vision and prevent more serious vision loss.  Prognosis is dependent on the extent of the damage and the size of the occlusion.

Eye Injections

Vascular Endothelial Growth Factor (VEGF) is a protein that promotes the growth of abnormal blood vessels in the eye. Anti-VEGF injections are eye injections that are injected directly into the middle of the eye near the retina. Anti-VEGF medications are injected into the eye to prevent swelling of the macula (central portion of retina). Macular edema can be controlled for years with these medications.