Branch and Central Retinal Vein Occlusions

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Vein Occlusion

For the retina to function properly, it requires a continuous supply of blood and oxygen, which is provided by the retinal vascular system. Retinal vein occlusions (RVO) occur when a blood vessel (vein) in the retina becomes blocked. There are two types of RVO: branch retinal vein occlusions (BRVO) and central retinal vein occlusions (CRVO).

Branch Retinal Vein Occlusions (BRVO)

BRVO occurs when the smaller blood vessels that branch off from the central retinal vein become blocked. If the affected veins are near the macula, this can lead to swelling, a condition known as macular edema. BRVO may cause blurred central vision and, in some cases, can lead to the growth of new abnormal blood vessels that may leak fluid into the eye.

Central Retinal Vein Occlusions (CRVO)

CRVO occurs when there is a blockage in the central retinal vein. This blockage can damage the vein's structure, causing blood and fluid to leak into the retina, which can result in blurred central vision. Consequently, new abnormal blood vessels, which are prone to bleeding and leaking, may begin to form. This can lead to the appearance of dark streaks or spots (floaters) in your vision. CRVO is often associated with underlying conditions such as high blood pressure, diabetes, glaucoma, and various blood disorders.

Branch and Central Retinal Vein Occlusions Symptoms

In the early stages of RVO, patients may not notice symptoms. If you experience any sudden changes in your vision, it's crucial to see a retina specialist as soon as possible. Symptoms may include:

• Sudden or gradual vision loss
• Blurred vision
• Floaters
• Loss of depth perception
• Sensitivity to light
• In some cases, eye pain, particularly if a blocked retinal vein is causing increased pressure inside the eye, or for patients with neovascular glaucoma

Branch and Central Retinal Vein Occlusions Risk Factors

Age is a significant risk factor for RVO, particularly in individuals over the age of 40. Certain medical conditions can also increase the chances of developing this condition, such as:

• Diabetes
• Atherosclerosis
• High blood pressure/hypertension
• Glaucoma
• Prior history of RVO in one eye

Diagnosing Branch and Central RVO

Diagnosing RVO involves a combination of eye exams and imaging tests, including:

• Eye dilation: During an eye exam, the doctor will apply special drops to widen the pupil, allowing for a better examination of the retina.
• Fluorescein angiography: In this test, a colored dye is injected into the bloodstream. The dye travels to the blood vessels in the eye, and a special camera captures images to identify any abnormalities in the retina.
• Optical coherence tomography (OCT): This non-invasive technique uses infrared light waves to capture cross-sectional images of the retina.
• Fundus photography: This diagnostic and monitoring tool utilizes a specialized camera to capture detailed images of the retina, optic nerve, and blood vessels at the back of the eye.

Treating Branch and Central RVO

Currently, there's no way to reverse or cure blockages in the retinal vein. However, retina specialists can prevent or treat complications of RVO using various methods, including:

• Anti-vascular endothelial growth factor (anti-VEGF) medications: Anti-VEGF medications are a group of drugs used to inhibit the growth of blood vessels in the eye. Examples of anti-VEGF medications include Vabysmo, Eylea HD, Cimerli, and Lucentis, which are administered directly into the eye via injection. These medications can also help manage macular edema, a condition where fluid builds up in the macula.
• Vitrectomy: This surgical procedure involves the removal of the vitreous humor fluid from the eye, allowing the retina specialist to repair the eye.
• Panretinal Photocoagulation (PRP): PRP is a comprehensive laser treatment used on the peripheral retina to inhibit the growth of abnormal blood vessels in the eye. It can reduce the risk of severe vision loss by 60% over two years.
• Medications to manage risk factors: Treating underlying conditions, like high blood pressure and diabetes, can help reduce the risk of developing blood vessel problems.

Long-Term Care for Branch and Central RVO

Depending on the location and severity of the blockage, some individuals may experience permanent vision loss while others improve over time. While some individuals may experience permanent vision loss, others may see a gradual improvement in their vision over time. No matter your specific circumstances, it's essential to see a retina specialist regularly, especially to monitor for potential RVO development in your unaffected eye.