II. Epidemiology

  1. Onset in young adults (one third of cases in age <45 years old)
    1. Contrast with Central Retinal Artery Occlusion in older adults

III. Pathophysiology

  1. Venous Occlusion results in Retinal edema, Hemorrhage and vascular leak

IV. Types

  1. Nonischemic (75% of cases)
    1. Progresses to ischemic types in 30% of patients within 4 months
    2. Visual blurring
    3. Mild funduscopic findings
    4. No Relative Afferent Pupillary Defect
  2. Ischemic
    1. Marked Vision Loss
    2. Relative Afferent Pupillary Defect
    3. Marked funduscopic changes

V. Symptoms

  1. Monocular painless visual loss

VI. Signs

  1. Funduscopic Exam
    1. Retinal veins dilated tortuous
    2. Blood streaked Retina (esp. in ischemic type)
      1. Diffuse Retinal Hemorrhages radiating from optic disc ("Blood and thunder Retina")

VII. Management

  1. Urgent Ophthalmology Consultation
  2. No specific management to alter Hemorrhages
  3. Management is focused on reducing longerterm complications of Retinopathy including Glaucoma
    1. Non-urgent laser photocoagulation may be needed in some cases

VIII. Complications

IX. References

  1. Hartmann (2016) Crit Dec Emerg Med 30(6): 3-11

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Related Studies

Ontology: Central retinal vein occlusion (C0154841)

Concepts Disease or Syndrome (T047)
MSH D012170
ICD9 362.35
ICD10 H34.81
SnomedCT 193378003, 68478007
English CRVO - Central ret vein occln, CRVT - Central ret vein thromb, Centr retinal vein thrombosis, central retinal vein occlusion, occlusion of central retinal vein (diagnosis), occlusion of central retinal vein, occlusion of central retinal vein (physical finding), Central retinal vein occlusion, Cent retinal vein occlus, central retinal thrombosis vein, central occlusions retinal vein, retinal central vein occlusion, CRVO - Central retinal vein occlusion, CRVT - Central retinal vein thrombosis, Central retinal vein thrombosis, Central retinal vein occlusion (disorder)
Dutch centrale retinavene occlusie
German Verschluss der zentralen Netzhautvene
Italian Occlusione della vena centrale della retina
Portuguese Oclusão da veia central da retina
Spanish Oclusión de la vena central de la retina, oclusión de la vena retiniana central (trastorno), oclusión de la vena retiniana central
Japanese 網膜中心静脈閉塞, モウマクチュウシンジョウミャクヘイソク
French Occlusion de la veine centrale de la rétine, OVCR (Occlusion de la Veine Centrale de la Rétine)
Czech Okluze centrální retinální vény
Hungarian Vena centralis retinae elzáródás