Branch retinal vein occlusion

Branch retinal vein occlusion occurs when there is a blockage of the small veins in the retina. Arterial compression of the vein is believed to be the main cause of BRVO especially in the case of arteriosclerosis of the artery in the eyes.

1) Signs and symptoms

Asymptomatic especially involving nasal branch (patient not notice it)

Painless sudden onset blurry vision.

Some patient complaints scomata.

2) Fundus examination

Acute phase (intraretinal hemorrhages (usually flame shaped), retinal edema, and cotton-wool spots)

chronic stage (macula edema)

Neovascularization.

Upper branch vein occlusion

3) Complication

Macular pucker@ cellophane maculopathy

Macular edema that lead to reduce vision.

Optic atrophy

Ocular neovascularization

a) In anterior segment: Lead to neovascular glaucoma

b) In posterior segment: lead to vitreous hemorrhage.

macula edema

Central retinal vein Occlusion

Retinal vein occlusion is divided into central retinal occlusion and branch retinal occlusion. Meanwhile, central retinal vein occlusion is further divided into ischemic and non-ischemic types.

1) Causes of Central retinal vein occlusion

- Systemic vascular disease (HPT, DM, CVD)

- Blood dyscrasia (PCV, lymphoma, leukemia)

- Clotting disorder

- Vasculitis

- Paraproteinemia & Dysproteinemia.

2) Signs and symptoms

- Sudden onset

- Painless severe loss of central of vision.

3) Fundus examination of CRVO

- Retinal hemorrhage

- Dilated tortuous vein

- Cotton wool spot (in ischemic type)

- Macular edema

- Optic nerve edema

- Neovascularization of the disc

4) Complication

- Ocular neovascularization ( in anterior segment lead to neovascular glaucoma, posterior segment lead to Vitreous hemorrhage)

- Macular edema

- Macular pucker

- Optic atrophy

Macular pucker: Contracture of an abnormal scar tissue membrane (epiretinal membrane, ERM) which grows over the surface to the macula

5) Treatment

- No definitive treatment

- Treat the underlying systemic disease

- In treating NVD ( Laser: Panretinal photocoagulation)

Reference

1) http://emedicine.medscape.com/article/1223746-overview

2) http://www.bethesdaretina.com

3) http://www.bnretina.com/CommonConditions/occlusion.jsp