Retinal Vein Occlusion

Question 1

What is retinal vein occlusion (RVO)?

Answer 1

A blockage of the retinal veins, leading to impaired drainage of blood from the retina and potential vision loss.

Question 2

What are the types of retinal vein occlusion?

Answer 2

Central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO).

Question 3

What is the main cause of RVO?

Answer 3

Thrombosis or compression of the retinal vein, often associated with vascular risk factors.

Question 4

What are the symptoms of CRVO?

Answer 4

Painless, sudden loss of vision or blurring in one eye, often worse in the morning.

Question 5

What are the symptoms of BRVO?

Answer 5

Painless, sudden vision loss or blurring in part of the visual field, corresponding to the affected branch.

Question 6

What is the pathophysiology of RVO?

Answer 6

Vein blockage causes increased venous pressure, leading to retinal haemorrhages, oedema, and ischaemia.

Question 7

What are the risk factors for RVO?

Answer 7

Hypertension, diabetes, glaucoma, smoking, hyperlipidaemia, and thrombophilic conditions.

Question 8

What are the characteristic fundoscopic findings in CRVO?

Answer 8

“Blood and thunder” appearance with retinal haemorrhages, optic disc oedema, and dilated tortuous veins.

Question 9

What are the characteristic fundoscopic findings in BRVO?

Answer 9

Localised retinal haemorrhages and oedema along the affected vein branch.

Question 10

What is macular oedema in RVO?

Answer 10

Swelling of the macula due to leakage from damaged retinal capillaries, causing central vision loss.

Question 11

What are the complications of RVO?

Answer 11

Macular oedema, neovascularisation, vitreous haemorrhage, and neovascular glaucoma.

Question 12

What investigations are used to confirm RVO?

Answer 12

Fundoscopy, optical coherence tomography (OCT), and fluorescein angiography.

Question 13

What is the role of fluorescein angiography in RVO?

Answer 13

Identifies areas of ischaemia and leakage, guiding treatment decisions.

Question 14

What is the conservative management of RVO?

Answer 14

Control of underlying risk factors such as hypertension, diabetes, and hyperlipidaemia.

Question 15

What is the medical treatment for macular oedema in RVO?

Answer 15

Intravitreal anti-VEGF therapy (e.g., ranibizumab, aflibercept) or corticosteroids.

Question 16

What is the role of anti-VEGF therapy in RVO?

Answer 16

Reduces macular oedema and prevents vision loss by inhibiting vascular endothelial growth factor.

Question 17

What is the role of laser photocoagulation in RVO?

Answer 17

Used to treat ischaemic areas and prevent complications like neovascularisation.

Question 18

What are the differential diagnoses for RVO?

Answer 18

Central retinal artery occlusion (CRAO), diabetic retinopathy, and hypertensive retinopathy.

Question 19

What is the prognosis for CRVO?

Answer 19

Vision outcomes vary; severe ischaemic CRVO has a worse prognosis than non-ischaemic CRVO.

Question 20

What is the prognosis for BRVO?

Answer 20

Generally better than CRVO, but macular oedema can cause persistent vision loss if untreated.

Question 21

What is the significance of neovascularisation in RVO?

Answer 21

Indicates ischaemia and increases the risk of complications such as neovascular glaucoma.

Question 22

What lifestyle modifications can reduce the risk of RVO recurrence?

Answer 22

Smoking cessation, weight management, regular exercise, and control of blood pressure and lipids.

Question 23

What is the role of imaging in RVO diagnosis?

Answer 23

Optical coherence tomography (OCT) detects macular oedema, and fluorescein angiography identifies ischaemia.

Question 24

What are the systemic associations of RVO?

Answer 24

Conditions like hypercoagulable states, antiphospholipid syndrome, and vasculitis.

Question 25

Why is early treatment important in RVO?

Answer 25

Early treatment reduces complications like macular oedema and neovascularisation, preserving vision.