Branch retinal vein occlusion

Branch retinal vein occlusion

Branch retinal vein occlusion (BRVO) is a common retinal vascular disease of the elderly. It is caused by the occlusion of one of the branches of central retinal vein.[1]

Epidemiology

Risk factors

Studies have identified the following abnormalities as risk factors for the development of BRVO:

Diabetes mellitus was not a major independent risk factor.

Manifestations

Patients with BRVO usually complain of sudden onset of blurred vision or a central visual field defect. The eye examination findings of acute BRVO include superficial hemorrhages, retinal edema, and often cotton-wool spots in a sector of retina drained by the affected vein.The obstructed vein is dilated and tortuous.

The quadrant most commonly affected is the superotemporal (63%).

Retinal neovascularization occurs in 20% of cases within the first 6–12 months of occlusion and depends on the area of retinal nonperfusion. Neovascularization is more likely to occur if more than five disc diameters of nonperfusion are present and vitreous hemorrhage can ensue.[3]

Diagnosis and testing

The diagnosis of BRVO is made clinically by finding retinal hemorrhages in the distribution of an obstructed retinal vein.

Treatment

Several options exist for the treatment of BRVO. These treatments aim for the two of the most significant complications of BRVO, namely macular edema and neovascularization.[1]

Course and outcome

In general, BRVO has a good prognosis: after 1 year 50–60% of eyes have been reported to have a final VA of 20/40 or better even without any treatment. With time the dramatic picture of an acute BRVO becomes more subtle, hemorrhages fade so that the retina can look almost normal. Collateral vessels develop to help drain the affected area.

See also

References

  1. 1 2 Basic and clinical science course (2011–2012). Retina and vitreous. American Academy of Ophthalmology. pp. 150–154. ISBN 978-1615251193.
  2. Rogers, S; et al. (Feb 2010). "The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia.". Ophthalmology 117 (2): 313–9.e1. doi:10.1016/j.ophtha.2009.07.017. PMC 2945292. PMID 20022117.
  3. Myron Yanoff, Jay S. Duker (2009). Ophthalmology (3rd ed.). Mosby Elsevier. ISBN 9780323043328.
  4. Scott, IU; et al. (Sep 2009). "A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6.". Archives of ophthalmology 127 (9): 1115–28. doi:10.1001/archophthalmol.2009.233. PMC 2806600. PMID 19752420.
  5. Haller, JA; et al. (Dec 2011). "Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results.". Ophthalmology 118 (12): 2453–60. doi:10.1016/j.ophtha.2011.05.014. PMID 21764136.
  6. Karia, N (Jul 30, 2010). "Retinal vein occlusion: pathophysiology and treatment options.". Clinical ophthalmology (Auckland, N.Z.) 4: 809–16. doi:10.2147/opth.s7631. PMC 2915868. PMID 20689798.
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