Central retinal vein occlusion
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Central retinal vein occlusion, also CRVO, is when the
central retinal vein The central retinal vein (retinal vein) is a vein that drains the retina of the eye. It travels backwards through the centre of the optic nerve accompanied by the central retinal artery before exiting the optic nerve together with the central r ...
becomes occluded, usually through
thrombosis Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (th ...
. The central retinal vein is the venous equivalent of the
central retinal artery The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball. Structure The central retinal artery pierces the eyeball close to the optic nerve, sendin ...
and both may become occluded. Since the central retinal artery and vein are the sole source of blood supply and drainage for the
retina The retina (from la, rete "net") is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which the ...
, such occlusion can lead to severe damage to the retina and blindness, due to
ischemia Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems w ...
(restriction in blood supply) and
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...
(swelling). CRVO can cause ocular ischemic syndrome. Nonischemic CRVO is the milder form of the disease. It may progress to the more severe ischemic type. CRVO can also cause
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
.


Diagnosis

Despite the role of thrombosis in the development of CRVO, a systematic review found no increased prevalence of
thrombophilia Thrombophilia (sometimes called hypercoagulability or a prothrombotic state) is an abnormality of blood coagulation that increases the risk of thrombosis (blood clots in blood vessels). Such abnormalities can be identified in 50% of people who ...
(an inherent propensity to thrombosis) in patients with retinal vascular occlusion.


Treatment

Treatment consists of Anti-VEGF drugs like
Lucentis Ranibizumab, sold under the brand name Lucentis among others, is a monoclonal antibody fragment ( Fab) created from the same parent mouse antibody as bevacizumab. It is an anti-angiogenic that is approved to treat the "wet" type of age-related ...
or intravitreal steroid implant (Ozurdex) and Pan-Retinal Laser Photocoagulation usually. Underlying conditions also require treatment. CRVO without
ischemia Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems w ...
has better visual prognosis than ischemic CRVO. A systematic review studied the effectiveness of the anti-VEGF drugs
ranibizumab Ranibizumab, sold under the brand name Lucentis among others, is a monoclonal antibody fragment ( Fab) created from the same parent mouse antibody as bevacizumab. It is an anti-angiogenic that is approved to treat the "wet" type of age-related ...
and pagatanib sodium for patients with non-ischemic CRVO. Though there was a limited sample size, participants in both treatment groups showed improved visual acuity over 6 month periods, with no safety concerns.


See also

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Central retinal artery occlusion Central retinal artery occlusion (CRAO) is a disease of the eye where the flow of blood through the central retinal artery is blocked (occluded). There are several different causes of this occlusion; the most common is carotid artery atherosclero ...
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Branch retinal artery occlusion Branch retinal artery occlusion (BRAO) is a rare retinal vascular disorder in which one of the branches of the central retinal artery is obstructed. Presentation Abrupt painless loss of vision in the visual field corresponding to territory of the ...
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Branch retinal vein occlusion Branch retinal vein occlusion is a common retinal vascular disease of the elderly. It is caused by the occlusion of one of the branches of central retinal vein. Signs and symptoms Patients with branch retinal vein occlusion usually have a sudden ...
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Eylea Aflibercept, sold under the brand names Eylea and Zaltrap, is a medication used to treat wet macular degeneration and metastatic colorectal cancer. It was developed by Regeneron Pharmaceuticals and is approved in the United States and the Europ ...
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Iridodialysis Iridodialysis is a localized separation or tearing away of the iris from its attachment to the ciliary body.Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. Cassin, B. and Solomon, ...
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Ischemic optic neuropathy Ischemic optic neuropathy (ION) is the loss of structure and function of a portion of the optic nerve due to obstruction of blood flow to the nerve (i.e. ischemia). Ischemic forms of optic neuropathy are typically classified as either anterior is ...


References


External links

{{DEFAULTSORT:Central Retinal Vein Occlusion Disorders of choroid and retina