Central Retinal Vein Occlusion

Question 1

Risk Factors of Central Retinal Vein Occlusion (6).

Answer 1

1. Cardiovascular Risk Factors : Hypertension, High Cholesterol, Smoking.
2. Diabetes.
3. Glaucoma.
4. Systemic Inflammatory Diseases e.g. SLE.
5. Age.
6. Polycythaemia.

Question 2

Pathophysiology of Central Retinal Vein Occlusion (5).

Answer 2

1. Central Retinal Vein runs through Optic Nerve and is responsible for draining blood from retina and is a convergece of 4 branched veins.
2. Blockage causes pooling of blood in the retina.
3. Increased leakage of fluid to cause macular oedema and retinal haemorrhages.
4. Damage tissues in retina and cause a loss of vision.
5. Release of VEGF (stimulates neovascularisation).

Question 3

Clinical Presentation of Central Retinal Vein Occlusion (3).

Answer 3

1. Blockage of 1 branch - problem in area drained by the branch.
2. Blockage of all 4 branches/Central Retinal Vein - problem in whole retina.
3. Sudden Painless Loss of Vision.

Question 4

Fundoscopy Findings of Central Retinal Vein Occlusion (4).

Answer 4

1. Flame and Blot Haemorrhages.
2. Optic Disc Oedema.
3. Macular Oedema.
4. Widespread Hyperaemia and Haemorrhages (‘Stormy-Sunset’ Appearance).

Question 5

Aim of Management of Central Retinal Vein Occlusion.

Answer 5

Treat Macular Oedema and Prevent Complications e.g. Neovascularisation of Retina, Iris and Glaucoma.

Question 6

Management of Central Retinal Vein Occlusion (3).

Answer 6

1. Laser Photocoagulation.
2. Intravitreal Steroids e.g. Dexamethasone Intravitreal Implant.
3. Anti-VEGF Therapies e.g. Ranibizumab, Aflibercept, Bevacizumab.