Retinal Vein Occlusion (RVO) is a blockage in a blood vessel of your eye that can result in vision loss. Occlusion (blockage) of a retinal vein is a common cause of sudden painless reduction in vision in older people. Damage to the retina can lead to loss of sight. The condition is uncommon under the age of 60 but becomes more frequent in later life.
There are two distinct types of Retinal Vein Occlusion:
Central Retinal Vein Occlusion (CRVO) - a blockage in the retina's main vein.
Branch Retinal Vein Occlusion (BRVO) - a blockage in a smaller retinal vein.
What Is Likely To Be The Visual Outcome?
While gradual spontaneous improvement in vision is possible in a minority of patients, without treatment the vision in most patients will remain decreased or even worsen. The ultimate visual outcome cannot be predicted for anyone. In general, the more severe the occlusion and associated macular oedema, the less likely the vision will improve spontaneously.
Diagnosis
The following tests available at Sood Eye Care, provide digital images of the retina and its blood circulation. These tests are recommended to help monitor the condition and decide the most appropriate treatment:
- Retinal photography
- Fluorescein angiography
- Optical coherence tomography
Treatment options
Treatment options proven to be effective in reducing macular oedema and improving vision to some degree include Intravitreal injection (injection of medicine into the eye) of vascular endothelial growth factor (VEGF) inhibitors such as Accentrix, Eylea, and Avastin or steroids such as Triamcinolone.
Laser is sometimes used to treat macular oedema but is now considered a second-line treatment for most cases based on visual outcomes and limitations. For instance, if there is significant haemorrhage in the retina, laser cannot be performed until the haemorrhage resolves spontaneously, which may take a few months.
Additional Problems May Arise Following Retinal Vein Occlusion (RVO)
In response to a RVO, some patients will develop an abnormal growth of fragile new blood vessels (retinal neovascularization) on the surface of the retina months or years after initial diagnosis. These blood vessels generally do not have any associated symptoms unless they rupture and bleed. In general, rupture is spontaneous and unpredictable, and if there is a significant amount of haemorrhage into the vitreous cavity of the eye, vision can be dramatically reduced. Although the blood may resolve spontaneously in some cases, it can take weeks or months depending on the severity.
If neovascularization is detected on a follow-up office visit, laser can be administered to shrink the abnormal fragile vessels in order to minimize the risk of vitreous haemorrhage and vision loss. Laser does not guarantee that there will be no future haemorrhaging, but it does significantly lower this risk. Occasionally if there is a very severe or persistent (non-clearing) vitreous haemorrhage, vitrectomy surgery may be warranted to remove the blood.
Our State-Of-The-Art Equipment for Retinal Vein Occlusion Treatment
- Slit Lamp Biomicroscopy ( Zeiss, Germany)
- Indirect Ophthalmoscope (Heine, Germany)
- Optical Coherence Tomography OCT (Nidek, Japan)
- Digital imaging DI / Fluorescein Angiography FFA (Zeiss VISUCAM 500, Germany)
Why are follow-up visits necessary?
About 20% of patients with retinal vein occlusions develop abnormal blood vessels growing on the iris at the front of the eye or on the retina. These abnormal blood vessels can bleed or cause a marked pressure rise in the eye leading to further loss of vision. This can normally be prevented by laser treatment to the retina, which is most effective if applied before vision is lost. For this reason, patients with retinal vein occlusions are normally checked every four to six weeks for 9-12 months.
Are there any restrictions or precautions?
There is no reason to limit one’s activities, to avoid reading, to avoid watching tv, etc. However, when one has blurred vision in one eye for any reason, one’s depth perception is hampered. To the degree that this is true, one should be very careful doing anything which requires the ability to judge distances such as working around machinery, climbing on ladders and scaffolds, pounding nails, pouring hot liquids, and driving. It is relatively uncommon for a similar process to affect the other eye, and blurry vision in one eye does not in any way harm the “good eye”.
When should a patient come back before his/her appointment?
A patient should come back sooner than scheduled if there is a marked decrease in vision or if the eye becomes painful.
Have questions or concerns about your eye health? Feel free to get in touch with our dedicated team of experts. We‘re here to help you see the world more clearly”. Contact Us on +91 872 598 7940.
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