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ALL / Ophthalmology
Central retinal vein occlusion
Central retinal vein occlusion
Central retinal vein occlusion (CRVO) is a differential for sudden painless loss of vision.Risk factors
- increasing age
- hypertension
- cardiovascular disease
- glaucoma
- polycythaemia
Features
- sudden, painless reduction or loss of visual acuity, usually unilaterally
- fundoscopy
- widespread hyperaemia
- severe retinal haemorrhages - 'stormy sunset'
A key differential is branch retinal vein occlusion (BRVO) - this occurs when a vein in the distal retinal venous system is occluded and is thought to occur due to blockage of retinal veins at arteriovenous crossings. It results in a more limited area of the fundus being affected.
Fundoscopy showing branch retinal vein occlusion
BRVO vs CRVO - typical fundoscopy findings
Management
- the majority of patients are managed conservatively
- indications for treatment in patients with CRVO include:
- macular oedema - intravitreal anti-vascular endothelial growth factor (VEGF) agents
- retinal neovascularization - laser photocoagulation
Fundoscopy image showing a central retinal vein occlusion
+PassMedicine Notes
Central retinal vein occlusion (CRVO) is a differential for sudden painless loss of vision.
Risk factors- increasing age
- hypertension
- cardiovascular disease
- glaucoma
- polycythaemia
- sudden, painless reduction or loss of visual acuity, usually unilaterally
- fundoscopy
- widespread hyperaemia
- severe retinal haemorrhages - 'stormy sunset'
A key differential is branch retinal vein occlusion (BRVO) - this occurs when a vein in the distal retinal venous system is occluded and is thought to occur due to blockage of retinal veins at arteriovenous crossings. It results in a more limited area of the fundus being affected.
Management- the majority of patients are managed conservatively
- indications for treatment in patients with CRVO include:
- macular oedema - intravitreal anti-vascular endothelial growth factor (VEGF) agents
- retinal neovascularization - laser photocoagulation
