CV

Central Retinal Vein Occlusion

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Central Retinal Vein Occlusion

  • 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
  • Pathophysiology
  1. Venous Occlusion results in Retinal edema, Hemorrhage and vascular leak
  • 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
  • Symptoms
  1. Monocular painless visual loss
  • 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")
  • 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
  • Complications
  • References
  1. Hartmann (2016) Crit Dec Emerg Med 30(6): 3-11