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Central Retinal Vein Occlusion: Causes & Treatment

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Central retinal vein occlusion is a health condition in which your central retinal vein is blocked, preventing blood from flowing properly to your retina. This can cause multiple complications related to your eye health, and it can lead to permanent vision loss.

It mostly affects adults over the age of 50.

Symptoms of Central Retinal Vein Occlusion (CRVO)

With central retinal vein occlusion (CRVO), the main vein to your retina becomes blocked. This blockage can cause naturally occurring fluids, including blood, to spill into your retina.

It can also cause swelling in the macula. Circulation is reduced, which can cause nerve cells in your eye to die.

Overall, CRVO is a serious condition that should be treated promptly once detected.

Common symptoms of central retinal vein occlusion include the following:

  • Vision loss
  • Vision blurriness
  • Floaters
  • Eye pain
  • Eye pressure

Generally, eye pain and eye pressure signal a more severe case of CRVO. Regardless, seek treatment for central retinal vein occlusion as soon as possible as permanent vision and eye health complications are possible.

Causes of Retinal Vein Occlusion

CRVO is caused by a blood clot blocking blood flow in your central retinal vein. This blockage then leads to further issues, as blood carries oxygen and nutrients to cells, which are essential to their survival. Rather than flow where it is needed, blood may build pressure near the blockage as well as spill into areas where it can cause further complications.

Some conditions that can cause stiffness or narrowing in your arteries can increase your risk of central retinal vein occlusion.

Risk Factors

Central retinal vein occlusion is most common in adults over 50 years old, with 90 percent of patients falling in that age group. You have a greater risk of CRVO if you have a health condition that affects blood flow, including the following:

  • High blood pressure
  • Diabetes
  • Arteriosclerosis
  • Glaucoma
  • Hyperlipidemia

Other associated risk factors include smoking, being African American, taking certain medications, having certain STIs (such as HIV or syphilis), and more. If you’re worried you may be at risk for central retinal vein occlusion, you can talk to your doctor about your risk factors and what you can do to reduce the factors that are within your control.

Diagnosis of Central Retinal Vein Occlusion

To diagnose central retinal vein occlusion, your doctor will likely dilate your pupils. Then, they will look into your retina with a special magnifying device and light.

Many doctors will also use optical coherence tomography (OCT) to check your retina. This is a noninvasive test where an imaging machine is used to map your retina’s layers and measure their thickness.

Sometimes, a doctor might also choose to perform fluorescein angiography, where a safe yellow dye called fluorescein is injected into your veins. A special camera can then photograph as it travels, helping a doctor to see blockages.

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CRVO Treatments

The primary goal when treating CRVO is to prevent leakage in the retina. The macular swelling that leakages can cause can do permanent damage to your vision and will worsen over time if untreated. Your doctor may also use injectable anti-VEGF medications and steroids in some cases to further reduce swelling.

Severe CRVO sometimes also warrants laser eye surgery, where a laser is used to make tiny, precise burns that reduce your bleeding and help prevent your blood pressure from rising.

It’s generally not possible to completely “cure” central retinal vein occlusion, as no totally effective medical treatment is available at this time. However, proper treatment can reduce the severity of a patient’s symptoms and help stabilize their vision.

Outlook for CRVO

The outlook for central retinal vein occlusion treatment is best in younger patients. Generally speaking, a patient’s prognosis is linked to their initial visual acuity. A better level of visual acuity at the start of your treatment usually means you have a better chance of stabilization or improvement.

Treatment results can take months to fully see. Some people don’t experience any visual improvement, but most see at least some positive change. As with many eye health conditions, the severity of your CRVO will often determine your outlook once you’re getting the appropriate treatments.

Prevention of Central Retinal Vein Occlusion

It is not possible to completely prevent CRVO, but you can reduce your risk of developing it by adopting some healthy habits, including these:

  • Exercise regularly.
  • Eat a diet low in fats.
  • Maintain a healthy body weight.
  • Stop smoking and any other drug use that may affect blood flow.

Additionally, if you have a condition that already puts you in a high-risk group, such as diabetes, closely follow your doctor’s recommendations about how to control your symptoms.

References

  1. A Brief History of Anti-VEGF for the Treatment of Ocular Angiogenesis. (August 2012). The American Journal of Pathology.
  2. Anti-VEGF Treatments. (March 2019). American Academy of Ophthalmology.
  3. Central Retinal Vein Occlusion. (May 2022). StatPearls.
  4. What Is Central Retinal Vein Occlusion (CRVO)? (January 2022). American Academy of Ophthalmology.
  5. What Is Optical Coherence Tomography? (March 2022). American Academy of Ophthalmology.
  6. Risk Factors for Central and Branch Retinal Vein Occlusion: A Meta-Analysis of Published Clinical Data. (June 2014). Journal of Ophthalmology.
  7. Guidelines for the Management of Retinal Vein Occlusion by the European Society of Retina Specialists (EURETINA). (2019). Ophthalmologica.
  8. Risk Factors for Central Retinal Vein Occlusion. (May 1996). JAMA Ophthalmology.

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