Central Retinal Vein Occlusion

Question 1

what are the causes of CRVO?

Answer 1

• Raised intraocular pressure – chronic glaucoma, hypertension
• Hyper viscosity syndromes – polycythaemia, anticardiolipin antibodies
• Vessel wall disease – diabetes, sarcoidosis, hyperlipidaemia, inflammatory eye disease, renal disease

Question 2

what is the pathophysiology of CRVO?

Answer 2

• Branch vein occlusion more common
• Abnormality of the blood itself
• an abnormality of the venous wall
• an increased ocular pressure

Question 3

what are the clinical features of CRVO?

Answer 3

• sudden, painless, unilateral visual loss
• particularly central vision – range of visual loss if macula involved
• vision not improved with pinhole
• if severe = RAPD

Question 4

what are the features of CRVO on fundoscope?

Answer 4

Retinal flame haemorrhage
Torturous vessels
Swollen disc
Cotton wool spots

Torturous vessels
Neovascularisation
o Grow onto iris – neovascular or rubeotic glaucoma “stormy sunset appearance”

Question 5

what are the clinical features of a branch retinal vein occulsion?

Answer 5

o Painless disturbance
o Asymptomatic
o May be aware of loss of field
o Inferior?

Question 6

what is the management of CRVO if no signs of ischaemia?

Answer 6

observe every 3 months

Question 7

what is the management of CRVO if ischaemia but no neovascularisation?

Answer 7

observe carefully (4-6 weeks)

Question 8

what is the management of CRVO if ischaemia with neovascularisation?

Answer 8

urgent argon laser, fibrinolysin