The ABCs of RVO: A review of retinal venous occlusion

Abstract

Retinal vein occlusions are important causes of loss of vision; indeed, they are the second most common retinal vascular disease, following diabetic retinopathy. For this reason alone, primary eye-care providers must be well versed in diagnosis and management. Risk factors, though not universally agreed upon, include but are not limited to advancing age, systemic hypertension, arteriolarsclerosis, diabetes, hyperlipidaemia, blood hyperviscosity, thrombophilia, ocular hypertension and glaucoma. Typically, visual loss is secondary to macular oedema and/or retinal ischaemia. Treatment modalities have included observation, systemic thrombolysis and haemodilution, radial optic neurotomy, chorioretinal anastomosis, vitrectomy, laser photocoagulation and intravitreal injection of anti-inflammatory and, most recently, anti-vascular endothelial growth factors.

Development of a Novel Model of Central Retinal Vascular Occlusion and the Therapeutic Potential of the Adrenomedullin–Receptor Activity–Modifying Protein 2 System

“…39 Retinal hemorrhage is the most characteristic phenotype of CRVO and is not observed in central retinal artery occlusion. 40 It is caused by extravasation of blood due to venous occlusion. In this model, retinal hemorrhage typical of CRVO was observed.…”

Fellow Eye Changes in Patients With Nonischemic Central Retinal Vein Occlusion

“…Furthermore, the increased expression of adhesion molecules during inflammation causes leukostasis, which can cause physical obstruction of capillary lumens resulting in nonperfusion. 32 Dehydration and hypercoagulability disorders, additional CRVO risk factors, 6 may also lead to capillary nonperfusion. The subclinical nature of these changes preceding clinical disease may explain why the majority of our fellow eye subjects did not report any of the known risk factors for CRVO, yet had a history of nonischemic CRVO in 1 eye and decreased microvascular density in the fellow eye.…”

“…1 Although a number of major and minor systemic risk factors have been identified, 2–6 a considerable number of patients with CRVO present without identifiable risk factors. Thus, despite years of research since its first description in 1855, 7 its pathogenesis remains poorly understood.…”

Thrombosis and Hemorrhage in Diabetic Retinopathy: A Perspective from an Inflammatory Standpoint

“…Retinal vein occlusion is an important cause of retinal vascular disease and vision loss, with an overall incidence in of approximately 1 to 2% in people older than 40 years. 41 Santiago et al 42 have examined the potential effects of diabetes on the prevalence of central retinal vein occlusion (CRVO) and its outcomes. This retrospective chart review of 19,648 subjects over a 4-year period showed that CRVO was observed at a similar prevalence in diabetic and nondiabetic subjects; however, diabetes was associated with worse anatomical outcomes, including disc neovascularization and panretinal photocoagulation.…”