Venous retinal occlusions

"Vascular retinal occlusions frequently occur in patients with cardiovascular risk factors. Therefore, collaboration among specialists is very important for the comprehensive management of this pathology". 

DR. MANUEL SÁENZ DE VITERI VÁZQUEZ
SPECIALIST. OPHTHALMOLOGY DEPARTMENT

Retinal vein occlusion (RVO) is the second most frequent cause of vision loss due to retinal vascular pathology, after diabetic retinopathy.

The retina is the layer at the back of the eye that receives the luminous stimuli and perceives the images that will be sent to our brain. This pathology is produced when a thrombus occludes the central vein of the retina or any of its branches.

Diseases such as high blood pressure, diabetes mellitus and/or hypercholesterolemia are risk factors for the development of this pathology. Similarly, pathologies that increase the viscosity of the blood or that favor the formation of thrombi increase the risk.

Venous obstruction produces an increase in pressure in the affected vessel, as well as the release of biochemical factors that increase vascular permeability, producing a leakage of liquid into the retinal tissue which, if it accumulates in the macula (central portion of the retina), will affect the patient's vision (macular edema). In addition, the supply of oxygen to the retina may be hindered (ischemic VRF), which stimulates the growth of new vessels that try to supply the deficit of blood supply. However, far from helping to solve the problem, these vessels are abnormal and can produce important complications in the eye.

Therefore, the key to the management of retinal venous occlusions consists of early diagnosis and treatment of eye complications, as well as the evaluation and control of our patients' cardiovascular risk factors.

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What are the symptoms of retinal vein occlusions?

The most frequent symptom is the sudden and painless loss of visual acuity.

The degree to which vision is affected will depend on the extent of the damage, the location of the obstruction, as well as the presence of macular edema or ischemia.

The most common symptoms are:

  • Decrease in visual acuity.
  • Distortion of the images.

Do you have any of these symptoms?

You may have a retinal vein occlusion

What are the causes of retinal vein occlusions?

There is often a history of high blood pressure or glaucoma, although on many occasions the cause is not clear and tests are necessary to rule out a greater risk of the body suffering from thrombosis, since what has happened in the eye can also happen in other parts of the body.

Sometimes the cause is not known for sure and in these cases it may be due to an anatomical variation exclusive to the eye.

What are its complications?

Although in some cases, macular edema may resolve spontaneously, deferring its treatment may produce a permanent decrease in visual acuity.

On the other hand, the development of neovasae can lead to retinal detachment by traction of the same, glaucoma (increased intraocular pressure), in addition to bleeding inside the eye. All these complications can cause blindness.

How are retinal vein occlusions diagnosed?

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The diagnosis of retinal venous occlusions is made by detecting the characteristic retinal alterations in a fundus examination, mainly localized hemorrhages (in the case of venous branch occlusion), or scattered throughout the retina (in the case of central vein occlusion). In some cases it is necessary to visualize the blood vessels with a contrast medium by means of a test called fluorescein angiography.

For the evaluation of macular edema, the use of optical coherence tomography (OCT) is fundamental, which allows the different layers of the retina to be analyzed and the presence of edema to be detected early, even before signs appear on the scan or the patient experiences visual alterations. The ophthalmologist is the professional who must analyze all these explorations.

How are retinal vein occlusions treated?

We carry out a multidisciplinary treatment by means of the collaboration among the different specialists of the Clinic to evaluate in an integral way each patient and to improve the control of their cardiovascular risk factors.

The treatment of macular edema is performed through the use of antiangiogenic drugs and intraocular corticoids, which block the action of the main biochemical factors responsible for fluid leakage.

Complications such as retinal detachment, glaucoma and intraocular bleeding usually require surgical treatment for their resolution.

When the presence of new vessel proliferation in the retina is detected, the treatment consists of the application of a laser treatment known as panphotocoagulation. In recent years new application modalities have been developed with safer and more effective laser sources.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Ophthalmology
of the Clínica Universidad de Navarra

Equipped with the latest technology, the Department of Ophthalmology has the necessary equipment, both technical and human, to offer comprehensive and specific assistance to each patient.

We are one of the few centers that have a microsurgery laboratory for the improvement of clinical practice.

Organized in specialized units

  • Cornea and eye surface
  • Retina
  • General Ophthalmology
  • Refraction defects
  • Oculoplastic
  • Pediatric ophthalmology
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Why at the Clinica?

  • More than 25 years of experience.
  • Experts in the diagnosis and treatment of ocular pathologies.
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