Central Retinal Vein Occlusion

Question 1

What is central retinal vein occlusion (CRVO)?

Answer 1

It is defined as a condition in which there is sudden occlusion of the vein, which is responsible for draining all retinal capillaries

Question 2

What is the pathophysiological cause of central retinal vein occlusion?

Answer 2

There is atherosclerotic thickening of the central retinal artery, which leads to compression of the central retinal vein at an arteriovenous crossover point in the lamina cribosa

This results in endothelial damage, turbulent blood flow and thrombus formation

Question 3

What six risk factors are associated with central retinal vein occlusion?

Answer 3

Older Age

Open-Angle Glaucoma

Hypertension

Hyperlipidaemia

Diabetes Mellitus

Smoking

Question 4

What are the eight clinical features associated with central retinal vein occlusion?

Answer 4

Sudden Painless Unilateral Vision Loss

Flame & Blot Retinal Haemorrhages

Widespread Hyperaemia

Cotton Wool Spots

Optic Disc Oedema

Macula Oedema

Neovascularisation

Rapid Afferent Pupillary Defect

Question 5

What investigation is used to diagnose central retinal vein occlusion?

Answer 5

Blood Tests

Question 6

How are blood tests used to investigate central retinal vein occlusion?

Answer 6

They are used to exclude associated underlying causes

Question 7

What three blood tests should be conducted following central retinal vein occlusion diagnosis?

Answer 7

Full Blood Count

CRP Levels

Glucose Levels

Question 8

What is the most appropriate management step in suspected retinal vein occlusion?

Answer 8

Urgent ophthalmology referral

Question 9

What is the first line management option of central retinal vein occlusion?

Answer 9

Conservative Management

Question 10

What are the three conservative management options of central retinal vein occlusion?

Answer 10

Ophthalmology Follow Up 4 – 6 Weeks

Hypertension Management Optimisation

Diabetes Mellitus Management Optimisation

Question 11

What are the three pharmacological management options of central retinal vein occlusion?

Answer 11

Intravitreal Anti-Vascular Endothelial Growth Factor (VEGF) Agents

Intravitreal Steroid Implant

Laser Photocoagulation

Question 12

When are intravitreal anti-VGEF agents used to manage central retinal vein occlusion?

Answer 12

They are used to treat development of macular oedema in central retinal vein occlusion

Question 13

What is the mechanism of action of intravitreal anti-VEGF agents?

Answer 13

These agents are involved in reducing blood vessel leakage

Question 14

Name three intravitreal anti-VGEF agents

Answer 14

Ranibizumab

Aflibercept

Bevacizumab

Question 15

When are intravitreal steroid implants used to manage central retinal vein occlusion?

Answer 15

They are used to treat development of macular oedema in central retinal vein occlusion

Question 16

What is the mechanism of action of intravitreal steroid implants?

Answer 16

They are involved in reducing blood vessel leakage

Question 17

Name an intravitreal steroid implants used to manage central retinal vein occlusion

Answer 17

Dexamethasone

Question 18

When is laser photocoagulation used to manage central retinal vein occlusion?

Answer 18

It is used to treat development of neovascularisation in central retinal vein occlusion

Question 19

How is laser photocoagulation used to manage central retinal vein occlusion?

Answer 19

It can be used to destroy newly formed abnormal retinal blood vessel

Question 20

What are the four complications associated with central retinal vein occlusion?

Answer 20

Macula Oedema

Neovascularisation

Vitreous Haemorrhage

Secondary Glaucoma