5 - Opth - Acute loss of vision - Retinal Vein Occlusion

Question 1

2 types

Answer 1

central or branch vein occlusion

Question 2

Associated with?

Answer 2

HTN, DM, age, smoking, obesity, raised IOP, Polycythaemia

Question 3

What does it give? via..(secondary to?)

More common than?

Answer 3

unilateral visual loss - 2ndary to ischaemia and macular oedema

more common than arterial occlusion

Question 4

Presentation of Central RVO

Answer 4

-Variable VA -usually global impact

Question 5

What percent is non-ischaemic and ischaemic?

Answer 5

75% non and 25% ischaemic

Question 6

Features of non-ischaemic CRVO

Answer 6

• variable VA
• dilated, tortuous retinal veins
• widespread dotblot/flame haemorrhages

Question 7

Prognosis of non-ischaemic CRVO

Answer 7

good
~50% get near normal vision recovery
~30% progres to ischaemic

Question 8

Features of Ischaemic CRVO

Answer 8

• sudden severe visual loss and more severe retinal signs
• macular oedema
• widespread cotton wool spots
• MARKED RAPD

Question 9

Complications of Ischaemic CRVO

Answer 9

• permanent visual loss

- neo-vascularisation (VEGF) –> risk of vitreous haemorrhage and rubeotic glaucoma (new iris vessels block drainage)

Question 10

Branch retinal vein occlusion - prevalence vs CRVO + one other feature

Answer 10

not emergency

3x more common

Question 11

Presentation of BRVO

Answer 11

reduced VA (often central and worse on waking)
Visual field defects (often altitudinal)

Question 12

Fundoscopic findings (restricted to area drained by affected vein)

Answer 12

• haemorrhage
• cotton wool spots
• venous dilatation
• oedema

Question 13

Prognosis of BRVO

Answer 13

• spontaneous resolution in less severe cases

- neo-vascularisation - treat with laser photocoagulation