Retinal Vein Occlusion

Question 1

Pathophysiology of retinal vein occlusion

Answer 1

Thrombus in retinal vein
Venous congestion in retina
Fluid and blood leaks into retina
Causing macular oedema and retinal haemorrhage
Leading to retinal damage and vision loss

Question 2

Two types of RVO? Which types leads to neovascularisation?

Answer 2

Ischaemic
Non - ischaemic (in terms of the retina)

Ischaemic RVO causes neovascularisation

Question 3

Risk factors of RVO

Answer 3

Hypertension
High cholesterol
Diabetes
Smoking
High plasma viscosity (e.g., myeloma)
Myeloproliferative disorders
Inflammatory conditions (e.g., SLE)

Question 4

Signs and symptoms of RVO

Answer 4

Symptoms: sudden onset blurred vision/vision loss
Central vision loss if macula affected

Question 5

Management of RVO

Answer 5

Urgent assessment by ophthalmologist
Anti-VEGF drugs (ranibizumab, aflibercept)
Dexamethasone intravitreal implant (to treat macular oedema)
Laser photocoagulation (to treat neovascularisation)

Question 6

Investigations for RVO

Answer 6

fundoscopy:

Dilated tortuous retinal veins
Flame and blot haemorrhages (‘blood and thunder appearance’
Retinal oedema
Cotton wool spots
Hard exudates