Retinal vein occlusion

Question 1

Does retinal vein occlusion present with pain?

Answer 1

painless

Question 2

Risk factors for retinal vein occlusion?

Answer 2

Hypertension
High cholesterol
Diabetes
Smoking
Glaucoma
Systemic inflammatory conditions such as systemic lupus erythematosus

Question 3

What is the pathophysiology of retinal vein occlusion?

Answer 3

Blockage of a retinal vein causes pooling of blood in the retina. This results in leakage of fluid and blood causing macular oedema and retinal haemorrhages. This results in damage to the tissue in the retina and loss of vision. It also leads to the release of VEGF, which stimulates the development of new blood vessels (neovascularisation).

Question 4

List two characteristic findings of retinal vein occlusion of fundoscopy?

Answer 4

flame and blot haemorrhages
optic disc oedema
macula oedema
tortuous vessels

Question 5

Which systemic disease is retinal vein occlusion associated with?

Answer 5

systemic lupus erythematous

Question 6

Which blood tests should you do to investigate retinal vein occlusion?

Answer 6

FBC for leukaemia
ESR for inflammatory disorders
Serum glucose for diabetes

Question 7

Management of retinal vein occlusion?

Answer 7

Management in secondary care aims to treat macular oedema and prevent complications such as neovascularisation of the retina and iris and glaucoma. The options for this are:

Laser photocoagulation
Intravitreal steroids (e.g. a dexamethasone intravitreal implant)
Anti-VEGF therapies (e.g. ranibizumab, aflibercept or bevacizumab)

Question 8

List two modifiable risk factors for retinal vein occlusion

Answer 8

BP
lipids
diabetes
smoking