Central retinal vein occlusion, also CRVO, is when the
central retinal vein becomes occluded, usually through
thrombosis
Thrombosis () is the formation of a Thrombus, 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 (thrombocytes) and fib ...
. 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, sen ...
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 (; or retinas) is the innermost, photosensitivity, light-sensitive layer of tissue (biology), tissue of the eye of most vertebrates and some Mollusca, molluscs. The optics of the eye create a focus (optics), focused two-dimensional ...
, 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 ...
(restriction in blood supply) and
edema
Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...
(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 can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...
.
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 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 ...
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.
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See also
* 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 atheroscle ...
* 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. Although often grouped together under one term, the condition consists of two distinct subtypes: pe ...
* 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 ...
* Eylea
* Iridodialysis
*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