Retinal Vein Occlusion (1)

Question 1

What occurs here?
→ What does this lead to?

What is it characterised into?
→ What does the Ischaemic type have?

What are its risk factors?

Answer 1

➊ Clot forms in retinal veins and blocks drainage of blood from the retina
→ • Pooling of blood in retina → Macular oedema and retinal haemorrhage → Retinal tissue damage and Vision loss
• Release of VEGF, which stimulates neovascularisation

➋ Ischaemic and Non-ischaemic
→ • Worse vision
• More complications
• Worse prognosis for vision

➌ • HTN, High cholesterol, DM, Smoking
• Glaucoma
• SLE

Question 2

How does it present?

What is seen O/E?

Answer 2

➊ Sudden painless vision loss

➋ Stormy-sunset appearance
• Flame and blot haemorrhages
• Macular oedema
• Dilated/tortuous retinal veins

Question 3

How is it investigated?

How is it managed?

What are the complications?

Answer 3

➊ • Bloods - FBC, U&E, LFT, CRP/ESR, Lipids, Clotting, Glucose
• BP

➋ • Laser photocoagulation for neovascularisation
• Anti-VEGF for macular oedema
‣ Steroids if contraindicated e.g. CVA within 3 months, pregnancy

➌ • Neovascularisation – Due to release of VEGF
• Vitreous haemorrhage – Due to bleeding of new vessels