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CRVO Flashcards

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1
Q

What systemic disease usually causes a thrombus (in CRVO/BRVO)

A

Hypertension – artery gets so hardened that it pushes down on the vein and causes the vein to collapse
- platelets and blood cells stick together and form thrombus

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2
Q

What retinal findings is NOT found in CRVOs?

A

Fibrous proliferation

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3
Q

Which type of CRVO is more likely to give you neovascularization?

A

Ischemic

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4
Q

Is there a high likelihood of neovascularization in a non-ischemic CRVO?

A

NO

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5
Q

Where is the occlusion site of the thrombus in a non-ischemic CRVO?

A

Closer to where the vein leaves the ON

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6
Q

50% of all ischemic CRVOs get what ocular disease?

A

Neovascular Glaucoma

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7
Q

What % of ALL vein occlusions get NVG?

A

10%

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8
Q

In a non-ischemic CRVO, what’s the most common cause of vision loss?

A

Macular Edema

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9
Q

If we did a FA on a non-ischemic CRVO, would we see areas of ischemia?

A

Yes

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10
Q

Where is the site of occlusion in a BRVO?

A

at an artery traversing the vein in the retina (not in the ON like a CRVO)

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11
Q

What is the biggest fear of a patient having a CRVO?

A
  1. neovascularization of the angle
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12
Q

What 3 things can cause vision loss in a CRVO?

A
  1. Blood covering fovea
  2. Capillary nonperfusion
  3. macular edema
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13
Q

What 2 things can cause vision loss in BRVO?

A
  1. Blood covering fovea

2. Macular edema

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14
Q

Can non-ischemic CRVOs become ischemic?

A

Yes

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15
Q

If you have a CRVO, do you perform prophylactic PRP?

A

No! Refer it out for a lucentis or avastin injection

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16
Q

What’s the name of the study using lucentis to determine its tx use in macular edema present in a BRVO?

A

BRAVO

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17
Q

What % of CRVOs are non-ischemic? ischemic?

A 
NI = 80%
Isch = 20%
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18
Q

Where is the blockage for a ischemic vein occlusion?

A

at the lamina cribrosa

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19
Q

How many disc diopters are needed to be considered an “ischemic CRVO”?

A

50-75DD of non-perfused capillaries

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20
Q

What is the chance that a BRVO will get neovascularization?

A

0%

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21
Q

In what 2 conditions is a BRVO found?

A
  1. HTN

2. Hyperopia

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22
Q

The SCORE trial tested what?

Study These Flashcards
A

Tested use of intravitreal traimcinolone in macula edema

23
Q

What was the result from the SCORE study which studied the treatment of macular edema?

Study These Flashcards
A

1mg of triamcinolone is better due to less side effects

24
Q

The CRUISE study used what drug to assess macular edema

Study These Flashcards
A

Lucentis

- showed to shortest duration of macular edema at 3.3 mo.

25
The GENEVA study used what drug to test macular edema
Used Ozurdex (intravitreal steroid)
26
The Galileo study used what drug to treat macular edema
VEG-F Trap eye (i.e. Eyelea)
27
What percentage of people have veins that do not come together until within half of lamina cribrosa, putting them at risk for an Hemispheric Vein Occlusion
20%
28
If the thrombus cannot be forced out, what happens to the patient?
They'll get a CRVO and CRAO
29
In a BRVO, what % of cases will an artery cross over a vein?
91%
30
In HCRVO, what fraction of cases had an artery crossing over a vein? What fraction did not have the crossing?
1. 1/3 had artery crossing over vein | 2. > 1/3 had no crossing
31
Collateral vessels are found where in a BRVO?
at the crossing (where the artery is over vein) | - always in the retina
32
Collateral vessels are found where in a CRVO?
at the optic disc
33
What fraction of cases in HCRVO/CRVO show increased IOP? (but not BRVO)
1/3
34
ONH edema is found in what 2 diseases?
HCRVO | CRVO
35
There is an increased prevalence of what 2 eye conditions in HCRVO/CRVO?
1. Glaucoma | 2. OHT
36
What are the risk factors for a CRVO?
1. Systemic HTN 2. CV disease 3. DM 4. POAG
37
What are the risk factors for a BRVO?
1. Systemic HTN 2. CV disase 3. Glaucoma 4. Increased BMI at age 20 (NOT DM)
38
Neovascularization is found in what % of ischemic eyes?
40-60%
39
Neovascularization is found in what % for nonischemic CRVOs?
5%
40
Less than ____ % of CRVOs develop retinal neo
<10%
41
What fraction of BRVO cases recover VA of 20/20 or better without therapy
1/3 to 1/2
42
What % of BRVOs are ischemic (5DD of ischemia)? What % of these cases devlop neo?
50% are ischemic | 40% develop neo
43
T/F: In bRVO, neovascularization of the iris is rare
True
44
Nonischemic CRVOs may resolve completely without any complications in about what % of people?
10%
45
In about 50% of non-ischemic CRVO cases, what will vision be?
20.200 or worse
46
In more than 90% of patient's with ischemic CRVO, final VAs will be?
20/200 or worse
47
Anterior segment Neo with associated NCVG develops in what % of cases? When does it occur?
- 60% of cases | - found a few weeks up to 1-2 years
48
What is the % chance that the fellow eye will get a retinal vein occlusion in 2 years?
7%
49
The 4 year risk of developing 2nd venous occlusion is ___ in the same eye and ___ in the fellow eye.
2. 5% for the same eye | 11. 9% for the fellow eye
50
When is PRP performed?
When neovascularizatio is found
51
What type of PRP does a BRVO need with neo?
Sector photocoagulation
52
What is used to treat macular edema 2' to a BRVO?
Anti VEGF injections
53
When do you follow up and see a CRVO patient again?
every 6 months

Posterior Segment (8 decks)

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