retinal vein occlusion
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Etiology
- risk factors
- hyperviscosity syndrome (younger patients)
Epidemiology
- affects mostly elderly
Pathology
- thrombus formation in retinal vein
- reduced venous outflow
- macular edema may result from hydrostatic pressure & leakage of fluid
- glaucoma may result from angiogenesis in response to retinal vein occlusion
Clinical manifestations
- sudden onset blurry vision or vision loss in all or part of one eye
- painless[3]
- central retinal vein occlusion generally presents as painless blurred monocular vision
- branch retinal vein occlusion may be asymptomatic or present with scotoma or visual field defect
- afferent pupillary defect may be present
- pupil does not react to light
- pupil reacts to light in contralateral eye[3]
Laboratory
- tests for diabetes
- lipid panel
- evaluation for hyperviscosity syndrome
Diagnostic procedures
- ophthalmoscopy
- optic disc swelling
- dilated & tortuous veins
- flame-shaped retinal hemorrhage
- cotton wool spots[3]
- intraocular pressure
- pupil reflex response
- slit lamp examination
- visual field examination
- visual acuity testinn
Management
- no generally accepted acute management[3]
- control risk factors to prevent recurrence
- focal laser therapy for macular edema
- VEGF inhititor to prevent neovascularization is experimental
- I5863, temsirolimus, semaxinib
- prognosis:
- patients often regain useful vision
- vision rarely returns to normal
- depends on degree on visual impairment at the onset of symptoms[3]
More general terms
More specific terms
Additional terms
References
- ↑ PubMed Health: Retinal vein occlusion Central retinal vein occlusion; Branch retinal vein occlusion; CRVO; BRVO http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004583/
- ↑ Fonrose M eMedicine (Medscape): Retinal Vein Occlusion http://emedicine.medscape.com/article/798583-overview
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Medical Knowledge Self Assessment Program (MKSAP) 16, 18, 19. American College of Physicians, Philadelphia 2012, 2018, 2022.