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Posterior Segment > CRVO > Flashcards

CRVO Flashcards

1
Q

What systemic disease usually causes a thrombus (in CRVO/BRVO)

A

Hypertension – artery gets so hardened that it pushes down on the vein and causes the vein to collapse
- platelets and blood cells stick together and form thrombus

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2
Q

What retinal findings is NOT found in CRVOs?

A

Fibrous proliferation

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3
Q

Which type of CRVO is more likely to give you neovascularization?

A

Ischemic

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4
Q

Is there a high likelihood of neovascularization in a non-ischemic CRVO?

A

NO

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5
Q

Where is the occlusion site of the thrombus in a non-ischemic CRVO?

A

Closer to where the vein leaves the ON

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6
Q

50% of all ischemic CRVOs get what ocular disease?

A

Neovascular Glaucoma

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7
Q

What % of ALL vein occlusions get NVG?

A

10%

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8
Q

In a non-ischemic CRVO, what’s the most common cause of vision loss?

A

Macular Edema

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9
Q

If we did a FA on a non-ischemic CRVO, would we see areas of ischemia?

A

Yes

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10
Q

Where is the site of occlusion in a BRVO?

A

at an artery traversing the vein in the retina (not in the ON like a CRVO)

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11
Q

What is the biggest fear of a patient having a CRVO?

A
  1. neovascularization of the angle
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12
Q

What 3 things can cause vision loss in a CRVO?

A
  1. Blood covering fovea
  2. Capillary nonperfusion
  3. macular edema
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13
Q

What 2 things can cause vision loss in BRVO?

A
  1. Blood covering fovea

2. Macular edema

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14
Q

Can non-ischemic CRVOs become ischemic?

A

Yes

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15
Q

If you have a CRVO, do you perform prophylactic PRP?

A

No! Refer it out for a lucentis or avastin injection

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16
Q

What’s the name of the study using lucentis to determine its tx use in macular edema present in a BRVO?

A

BRAVO

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17
Q

What % of CRVOs are non-ischemic? ischemic?

A 
NI = 80%
Isch = 20%
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18
Q

Where is the blockage for a ischemic vein occlusion?

A

at the lamina cribrosa

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19
Q

How many disc diopters are needed to be considered an “ischemic CRVO”?

A

50-75DD of non-perfused capillaries

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20
Q

What is the chance that a BRVO will get neovascularization?

A

0%

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21
Q

In what 2 conditions is a BRVO found?

A
  1. HTN

2. Hyperopia

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22
Q

The SCORE trial tested what?

A

Tested use of intravitreal traimcinolone in macula edema

23
Q

What was the result from the SCORE study which studied the treatment of macular edema?

A

1mg of triamcinolone is better due to less side effects

24
Q

The CRUISE study used what drug to assess macular edema

A

Lucentis

- showed to shortest duration of macular edema at 3.3 mo.

25
Q

The GENEVA study used what drug to test macular edema

A

Used Ozurdex (intravitreal steroid)

26
Q

The Galileo study used what drug to treat macular edema

A

VEG-F Trap eye (i.e. Eyelea)

27
Q

What percentage of people have veins that do not come together until within half of lamina cribrosa, putting them at risk for an Hemispheric Vein Occlusion

A

20%

28
Q

If the thrombus cannot be forced out, what happens to the patient?

A

They’ll get a CRVO and CRAO

29
Q

In a BRVO, what % of cases will an artery cross over a vein?

A

91%

30
Q

In HCRVO, what fraction of cases had an artery crossing over a vein? What fraction did not have the crossing?

A
  1. 1/3 had artery crossing over vein

2. > 1/3 had no crossing

31
Q

Collateral vessels are found where in a BRVO?

A

at the crossing (where the artery is over vein)

- always in the retina

32
Q

Collateral vessels are found where in a CRVO?

A

at the optic disc

33
Q

What fraction of cases in HCRVO/CRVO show increased IOP? (but not BRVO)

A

1/3

34
Q

ONH edema is found in what 2 diseases?

A

HCRVO

CRVO

35
Q

There is an increased prevalence of what 2 eye conditions in HCRVO/CRVO?

A
  1. Glaucoma

2. OHT

36
Q

What are the risk factors for a CRVO?

A
  1. Systemic HTN
  2. CV disease
  3. DM
  4. POAG
37
Q

What are the risk factors for a BRVO?

A
  1. Systemic HTN
  2. CV disase
  3. Glaucoma
  4. Increased BMI at age 20

(NOT DM)

38
Q

Neovascularization is found in what % of ischemic eyes?

A

40-60%

39
Q

Neovascularization is found in what % for nonischemic CRVOs?

A

5%

40
Q

Less than ____ % of CRVOs develop retinal neo

A

<10%

41
Q

What fraction of BRVO cases recover VA of 20/20 or better without therapy

A

1/3 to 1/2

42
Q

What % of BRVOs are ischemic (5DD of ischemia)? What % of these cases devlop neo?

A

50% are ischemic

40% develop neo

43
Q

T/F: In bRVO, neovascularization of the iris is rare

A

True

44
Q

Nonischemic CRVOs may resolve completely without any complications in about what % of people?

A

10%

45
Q

In about 50% of non-ischemic CRVO cases, what will vision be?

A

20.200 or worse

46
Q

In more than 90% of patient’s with ischemic CRVO, final VAs will be?

A

20/200 or worse

47
Q

Anterior segment Neo with associated NCVG develops in what % of cases? When does it occur?

A
  • 60% of cases

- found a few weeks up to 1-2 years

48
Q

What is the % chance that the fellow eye will get a retinal vein occlusion in 2 years?

A

7%

49
Q

The 4 year risk of developing 2nd venous occlusion is ___ in the same eye and ___ in the fellow eye.

A
  1. 5% for the same eye

11. 9% for the fellow eye

50
Q

When is PRP performed?

A

When neovascularizatio is found

51
Q

What type of PRP does a BRVO need with neo?

A

Sector photocoagulation

52
Q

What is used to treat macular edema 2’ to a BRVO?

A

Anti VEGF injections

53
Q

When do you follow up and see a CRVO patient again?

A

every 6 months

Posterior Segment (8 decks)

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