Retinal Vein Occlusion of the Eye

Retinal vein occlusion (RVO) is caused by a blockage in any of the 4 veins which carries blood away from the retina.  In the eye, there is a single central vein which splits into 4 smaller veins to transport blood from each of the 4 quadrants of the retina.  If the blockage is in the;

• Central Vein (this is called Central Retina Vein Occlusion or CRVO)
• Quarter or Branch Vein (this is called Branch Vein Occlusion or BRVO)

The symptoms depend of which of the veins is occluded.  If the blockage is in the Branch Vein, then the visual loss will be a partial (or quadrantic) visual loss while the Central Vein Occlusion will have a worse outcome with usually complete central loss of vision.

Causes of Retina Vein Occlusion

• Age (especially over the age of 40 years)
• Atherosclerosis (stiffening of the blood vessels)
• Hypertension (high blood pressure)
• Glaucoma (high eye pressure)
• Diabetes
• Hyper viscosity states (such as leukaemia, lymphoma or auto-immune conditions)

Complications of Vein Occlusion

Visual loss may be permanent if the retina swelling is not treated quickly as the retina cells may die and form scarring.  In addition, the retina may have ischemic areas (lack of oxygen) similar to diabetic retinas resulting in new vessels formation which can lead to vitreous haemorrhage at the 3-4 month stage.

Treatment of Vein Occlusion

Treatment depends of the type and severity of the eye disease.  Your eye doctor may use one or a combination of the following treatment options to prevent complications of the vein occlusion;

1. Argon / Diode Laser Treatment treats vein occlusion in 2 ways;

• It reduces retina swelling or leakage
• It prevents the growth of new blood vessels in the eye

2. Intra-vitreal Anti-VEGF Injection blocks VEGF protein in the eye, thereby slowing the growth of new blood vessels in the eye. This will slow and stop the damage caused by these abnormal leaky blood vessels and also treat any retina swelling (known as oedema) to improve the vision

3. Surgery using Vitrectomy and/or Laser and/or Intra-vitreal Injection may be required if there is complication of vitreous haemorrhage caused by new vessel formation after the vein occlusion

Prognosis

The visual recovery varies from person to person.  Central vein occlusion has a worse prognosis compared to branch vein occlusion.  The earlier the condition is treated, the better the outcome.  Even after treatment, you will still need to take good care of any health conditions such as hypertension or atherosclerosis (which you may have) because there is a 5% risk of vein occlusion happening in the other eye.

See an Ophthalmologist as soon as possible to discuss your treatment options before the condition becomes untreatable

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